| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,580 |
2,186 |
$88K |
| E0601 |
Cont airway pressure device |
2,349 |
2,058 |
$68K |
| E0570 |
Nebulizer with compression |
2,028 |
1,821 |
$27K |
| A4604 |
Tubing with heating element |
943 |
813 |
$21K |
| E0562 |
Humidifier heated used w pap |
923 |
772 |
$18K |
| K0738 |
Portable gas oxygen system |
1,579 |
1,307 |
$15K |
| A7031 |
Replacement facemask interfa |
484 |
433 |
$14K |
| A7032 |
Replacement nasal cushion |
296 |
252 |
$8K |
| A7030 |
Cpap full face mask |
160 |
129 |
$8K |
| A7035 |
Pos airway press headgear |
660 |
593 |
$8K |
| A7038 |
Pos airway pressure filter |
1,503 |
1,347 |
$5K |
| E0260 |
Hosp bed semi-electr w/ matt |
87 |
77 |
$2K |
| A7034 |
Nasal application device |
64 |
51 |
$2K |
| A7046 |
Repl water chamber, pap dev |
246 |
220 |
$2K |
| E1130 |
Whlchr stand fxd arm ft rest |
98 |
88 |
$1K |
| E0431 |
Portable gaseous 02 |
33 |
25 |
$255.66 |
| A7003 |
Nebulizer administration set |
49 |
38 |
$59.60 |
| K0001 |
Standard wheelchair |
47 |
38 |
$0.00 |
| 90688 |
|
50 |
50 |
$0.00 |
| G0008 |
Admin influenza virus vac |
75 |
73 |
$0.00 |
| A4253 |
Blood glucose/reagent strips |
13 |
13 |
$0.00 |
| 90674 |
|
39 |
37 |
$0.00 |