| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
11,516 |
10,968 |
$645K |
| E0431 |
Portable gaseous 02 |
9,146 |
8,799 |
$79K |
| E0601 |
Cont airway pressure device |
1,184 |
1,152 |
$48K |
| E0470 |
Rad w/o backup non-inv intfc |
413 |
397 |
$23K |
| E0562 |
Humidifier heated used w pap |
439 |
433 |
$20K |
| A7030 |
Cpap full face mask |
249 |
246 |
$17K |
| A7031 |
Replacement facemask interfa |
459 |
450 |
$13K |
| E0471 |
Rad w/backup non inv intrfc |
53 |
52 |
$12K |
| A7032 |
Replacement nasal cushion |
211 |
187 |
$7K |
| E1392 |
Portable oxygen concentrator |
406 |
398 |
$7K |
| K0001 |
Standard wheelchair |
556 |
511 |
$6K |
| B4035 |
Enteral feed supp pump per d |
298 |
292 |
$6K |
| A4604 |
Tubing with heating element |
151 |
150 |
$6K |
| A7035 |
Pos airway press headgear |
378 |
367 |
$6K |
| A7034 |
Nasal application device |
97 |
95 |
$5K |
| A7038 |
Pos airway pressure filter |
1,637 |
1,522 |
$5K |
| A7037 |
Pos airway pressure tubing |
475 |
461 |
$5K |
| E0570 |
Nebulizer with compression |
153 |
151 |
$3K |
| T4534 |
Youth size pull-on |
61 |
57 |
$739.26 |
| K0195 |
Elevating whlchair leg rests |
13 |
13 |
$114.57 |
| T4523 |
Adult size brief/diaper lg |
12 |
12 |
$90.20 |
| T4530 |
Ped size brief/diaper lg |
12 |
12 |
$72.00 |
| T4522 |
Adult size brief/diaper med |
49 |
48 |
$42.00 |
| A4615 |
Cannula nasal |
35 |
26 |
$1.64 |