| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,503 |
8,095 |
$186K |
| E0431 |
Portable gaseous 02 |
5,746 |
5,500 |
$22K |
| A7030 |
Cpap full face mask |
438 |
435 |
$9K |
| A7031 |
Replacement facemask interfa |
563 |
531 |
$7K |
| E0601 |
Cont airway pressure device |
1,162 |
1,126 |
$5K |
| K0001 |
Standard wheelchair |
366 |
341 |
$4K |
| E0470 |
Rad w/o backup non-inv intfc |
550 |
534 |
$3K |
| A4604 |
Tubing with heating element |
342 |
341 |
$3K |
| B4035 |
Enteral feed supp pump per d |
558 |
524 |
$2K |
| A7035 |
Pos airway press headgear |
503 |
496 |
$2K |
| A7032 |
Replacement nasal cushion |
141 |
130 |
$2K |
| A7038 |
Pos airway pressure filter |
1,432 |
1,370 |
$2K |
| A7034 |
Nasal application device |
80 |
78 |
$2K |
| E0562 |
Humidifier heated used w pap |
104 |
104 |
$1K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
127 |
99 |
$1K |
| A7037 |
Pos airway pressure tubing |
313 |
312 |
$836.31 |
| B4034 |
Enter feed supkit syr by day |
39 |
39 |
$334.39 |
| T4522 |
Adult size brief/diaper med |
314 |
296 |
$202.51 |
| A7046 |
Repl water chamber, pap dev |
236 |
236 |
$163.41 |
| T4526 |
Adult size pull-on med |
27 |
24 |
$64.94 |
| E1392 |
Portable oxygen concentrator |
216 |
212 |
$61.14 |
| T4523 |
Adult size brief/diaper lg |
24 |
24 |
$0.00 |
| E0471 |
Rad w/backup non inv intrfc |
12 |
12 |
$0.00 |
| B9002 |
Enter nutr inf pump any type |
14 |
14 |
$0.00 |