| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
29,030 |
25,752 |
$610K |
| E0431 |
Portable gaseous 02 |
11,552 |
10,262 |
$56K |
| A7030 |
Cpap full face mask |
1,595 |
1,468 |
$50K |
| A7031 |
Replacement facemask interfa |
2,568 |
2,399 |
$45K |
| E0601 |
Cont airway pressure device |
1,834 |
1,624 |
$29K |
| K0001 |
Standard wheelchair |
2,720 |
2,427 |
$15K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,321 |
1,190 |
$14K |
| E0466 |
Home vent non-invasive inter |
212 |
193 |
$13K |
| E0570 |
Nebulizer with compression |
4,319 |
3,945 |
$13K |
| E0562 |
Humidifier heated used w pap |
2,091 |
1,826 |
$11K |
| E1392 |
Portable oxygen concentrator |
1,651 |
1,470 |
$11K |
| A7038 |
Pos airway pressure filter |
4,438 |
4,115 |
$9K |
| A7037 |
Pos airway pressure tubing |
2,047 |
1,891 |
$9K |
| A7035 |
Pos airway press headgear |
1,398 |
1,279 |
$9K |
| E0439 |
Stationary liquid 02 |
261 |
236 |
$6K |
| A7032 |
Replacement nasal cushion |
413 |
380 |
$6K |
| A7034 |
Nasal application device |
303 |
284 |
$5K |
| A7046 |
Repl water chamber, pap dev |
719 |
658 |
$3K |
| A4604 |
Tubing with heating element |
39 |
39 |
$656.57 |
| A7003 |
Nebulizer administration set |
1,502 |
1,342 |
$544.64 |
| A7005 |
Nondisposable nebulizer set |
138 |
130 |
$346.06 |
| E0443 |
Portable 02 contents, gas |
29 |
25 |
$63.18 |
| Q0513 |
Disp fee inhal drugs/30 days |
19 |
14 |
$52.80 |
| A7013 |
Disposable compressor filter |
46 |
41 |
$7.00 |
| A7015 |
Aerosol mask used w nebulize |
16 |
12 |
$6.07 |