| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
32,844 |
32,569 |
$384K |
| E0466 |
Home vent non-invasive inter |
2,683 |
2,680 |
$238K |
| E0431 |
Portable gaseous 02 |
16,534 |
16,305 |
$60K |
| E0601 |
Cont airway pressure device |
2,023 |
2,002 |
$24K |
| E0562 |
Humidifier heated used w pap |
1,925 |
1,901 |
$13K |
| A4604 |
Tubing with heating element |
1,030 |
1,026 |
$11K |
| E1392 |
Portable oxygen concentrator |
1,263 |
1,256 |
$8K |
| K0001 |
Standard wheelchair |
1,341 |
1,341 |
$7K |
| A7031 |
Replacement facemask interfa |
525 |
517 |
$7K |
| A7030 |
Cpap full face mask |
408 |
407 |
$5K |
| E0570 |
Nebulizer with compression |
4,996 |
4,960 |
$5K |
| E0260 |
Hosp bed semi-electr w/ matt |
585 |
580 |
$5K |
| A7038 |
Pos airway pressure filter |
2,374 |
2,334 |
$4K |
| A7034 |
Nasal application device |
571 |
563 |
$4K |
| A7035 |
Pos airway press headgear |
729 |
725 |
$2K |
| A7032 |
Replacement nasal cushion |
142 |
140 |
$2K |
| E0443 |
Portable 02 contents, gas |
433 |
428 |
$2K |
| A7033 |
Replacement nasal pillows |
52 |
51 |
$872.15 |
| A7046 |
Repl water chamber, pap dev |
234 |
234 |
$254.63 |
| A7003 |
Nebulizer administration set |
615 |
593 |
$151.69 |
| A7037 |
Pos airway pressure tubing |
13 |
13 |
$58.02 |
| A7005 |
Nondisposable nebulizer set |
32 |
32 |
$0.00 |
| E0630 |
Patient lift hydraulic |
104 |
104 |
$0.00 |