| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
14,311 |
11,304 |
$680K |
| A7030 |
Cpap full face mask |
1,683 |
1,388 |
$121K |
| E0601 |
Cont airway pressure device |
2,134 |
1,819 |
$113K |
| A7031 |
Replacement facemask interfa |
2,753 |
2,453 |
$100K |
| E0431 |
Portable gaseous 02 |
8,262 |
6,527 |
$67K |
| E0466 |
Home vent non-invasive inter |
230 |
194 |
$60K |
| A4604 |
Tubing with heating element |
2,096 |
1,815 |
$59K |
| E0562 |
Humidifier heated used w pap |
2,438 |
2,094 |
$45K |
| E0470 |
Rad w/o backup non-inv intfc |
380 |
324 |
$37K |
| A7032 |
Replacement nasal cushion |
1,005 |
901 |
$36K |
| A7034 |
Nasal application device |
785 |
662 |
$35K |
| A7038 |
Pos airway pressure filter |
5,864 |
5,318 |
$33K |
| E0570 |
Nebulizer with compression |
4,774 |
3,777 |
$31K |
| A7035 |
Pos airway press headgear |
1,699 |
1,432 |
$28K |
| E1392 |
Portable oxygen concentrator |
1,500 |
1,179 |
$16K |
| A7046 |
Repl water chamber, pap dev |
1,119 |
948 |
$9K |
| A7033 |
Replacement nasal pillows |
136 |
118 |
$3K |
| A7003 |
Nebulizer administration set |
1,822 |
1,285 |
$2K |
| A7039 |
Filter, non disposable w pap |
242 |
197 |
$2K |
| A7037 |
Pos airway pressure tubing |
52 |
37 |
$630.54 |
| E0443 |
Portable 02 contents, gas |
100 |
55 |
$628.11 |
| K0001 |
Standard wheelchair |
15 |
13 |
$242.02 |