| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
428 |
354 |
$10K |
| B4152 |
Ef calorie dense>/=1.5kcal |
47 |
41 |
$5K |
| B4150 |
Ef complet w/intact nutrient |
67 |
57 |
$4K |
| E0601 |
Cont airway pressure device |
202 |
171 |
$2K |
| K0001 |
Standard wheelchair |
101 |
84 |
$2K |
| A7031 |
Replacement facemask interfa |
63 |
54 |
$1K |
| E0431 |
Portable gaseous 02 |
101 |
83 |
$1K |
| A7030 |
Cpap full face mask |
77 |
65 |
$834.17 |
| E0255 |
Hospital bed var ht w/ mattr |
68 |
63 |
$738.53 |
| E0570 |
Nebulizer with compression |
234 |
223 |
$722.25 |
| E1392 |
Portable oxygen concentrator |
99 |
74 |
$616.83 |
| E0260 |
Hosp bed semi-electr w/ matt |
18 |
14 |
$615.03 |
| E0562 |
Humidifier heated used w pap |
30 |
28 |
$564.80 |
| A4239 |
Non-adju cgm supply allow |
12 |
12 |
$554.16 |
| A4604 |
Tubing with heating element |
118 |
105 |
$360.18 |
| B4034 |
Enter feed supkit syr by day |
15 |
12 |
$270.27 |
| A7034 |
Nasal application device |
14 |
13 |
$101.84 |
| A7035 |
Pos airway press headgear |
45 |
38 |
$81.93 |
| A7038 |
Pos airway pressure filter |
166 |
136 |
$66.85 |
| K0738 |
Portable gas oxygen system |
45 |
36 |
$65.16 |
| A7046 |
Repl water chamber, pap dev |
48 |
41 |
$1.52 |