| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,206 |
3,049 |
$122K |
| A7030 |
Cpap full face mask |
1,333 |
1,238 |
$115K |
| A7031 |
Replacement facemask interfa |
1,362 |
1,252 |
$74K |
| E0601 |
Cont airway pressure device |
1,827 |
1,625 |
$64K |
| A4604 |
Tubing with heating element |
2,321 |
2,154 |
$62K |
| A7034 |
Nasal application device |
665 |
619 |
$39K |
| A7038 |
Pos airway pressure filter |
2,711 |
2,499 |
$34K |
| K0738 |
Portable gas oxygen system |
1,143 |
1,115 |
$29K |
| A7032 |
Replacement nasal cushion |
380 |
351 |
$25K |
| A7035 |
Pos airway press headgear |
1,240 |
1,148 |
$25K |
| E0562 |
Humidifier heated used w pap |
866 |
612 |
$22K |
| E0570 |
Nebulizer with compression |
3,001 |
2,755 |
$18K |
| E1392 |
Portable oxygen concentrator |
1,002 |
904 |
$16K |
| E0260 |
Hosp bed semi-electr w/ matt |
481 |
448 |
$11K |
| A7046 |
Repl water chamber, pap dev |
920 |
858 |
$10K |
| A4927 |
Non-sterile gloves |
226 |
175 |
$3K |
| T4523 |
Adult size brief/diaper lg |
31 |
28 |
$2K |
| A7039 |
Filter, non disposable w pap |
248 |
231 |
$2K |
| B4035 |
Enteral feed supp pump per d |
14 |
12 |
$2K |
| A7033 |
Replacement nasal pillows |
50 |
46 |
$1K |
| K0001 |
Standard wheelchair |
50 |
48 |
$544.54 |
| A7003 |
Nebulizer administration set |
289 |
261 |
$464.04 |