| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
16,175 |
15,632 |
$854K |
| A7030 |
Cpap full face mask |
2,180 |
2,153 |
$125K |
| B4035 |
Enteral feed supp pump per d |
1,830 |
1,598 |
$120K |
| A7031 |
Replacement facemask interfa |
3,418 |
3,391 |
$113K |
| E0601 |
Cont airway pressure device |
3,860 |
3,778 |
$111K |
| E0431 |
Portable gaseous 02 |
8,846 |
8,645 |
$106K |
| A7034 |
Nasal application device |
1,881 |
1,851 |
$69K |
| A7032 |
Replacement nasal cushion |
1,989 |
1,957 |
$62K |
| E0562 |
Humidifier heated used w pap |
2,786 |
2,743 |
$48K |
| E1392 |
Portable oxygen concentrator |
1,794 |
1,757 |
$44K |
| A4604 |
Tubing with heating element |
1,747 |
1,735 |
$42K |
| B4152 |
Ef calorie dense>/=1.5kcal |
606 |
563 |
$42K |
| A7037 |
Pos airway pressure tubing |
2,862 |
2,823 |
$40K |
| E0603 |
Electric breast pump |
489 |
483 |
$39K |
| A7035 |
Pos airway press headgear |
2,766 |
2,723 |
$38K |
| B4150 |
Ef complet w/intact nutrient |
592 |
548 |
$33K |
| A7038 |
Pos airway pressure filter |
7,821 |
7,684 |
$32K |
| G0249 |
Provide inr test mater/equip |
198 |
191 |
$31K |
| E0570 |
Nebulizer with compression |
5,441 |
5,335 |
$24K |
| A7033 |
Replacement nasal pillows |
665 |
653 |
$18K |
| A7046 |
Repl water chamber, pap dev |
2,069 |
2,057 |
$17K |
| B4034 |
Enter feed supkit syr by day |
175 |
151 |
$8K |
| E0443 |
Portable 02 contents, gas |
135 |
135 |
$4K |
| K0001 |
Standard wheelchair |
344 |
343 |
$3K |
| A7003 |
Nebulizer administration set |
1,795 |
1,688 |
$3K |
| E0470 |
Rad w/o backup non-inv intfc |
50 |
49 |
$2K |
| A7039 |
Filter, non disposable w pap |
301 |
295 |
$1K |
| E0260 |
Hosp bed semi-electr w/ matt |
277 |
265 |
$1K |
| E0776 |
Iv pole |
366 |
359 |
$381.72 |
| A7013 |
Disposable compressor filter |
64 |
43 |
$23.19 |