| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
4,848 |
4,625 |
$232K |
| E1390 |
Oxygen concentrator |
2,686 |
2,675 |
$176K |
| A7030 |
Cpap full face mask |
2,088 |
2,081 |
$120K |
| E0570 |
Nebulizer with compression |
7,583 |
6,981 |
$105K |
| A7031 |
Replacement facemask interfa |
1,602 |
1,587 |
$54K |
| E0562 |
Humidifier heated used w pap |
1,730 |
1,661 |
$53K |
| A7037 |
Pos airway pressure tubing |
1,701 |
1,694 |
$27K |
| A7035 |
Pos airway press headgear |
2,205 |
2,195 |
$26K |
| A7038 |
Pos airway pressure filter |
2,403 |
2,334 |
$12K |
| E0431 |
Portable gaseous 02 |
562 |
557 |
$7K |
| A4604 |
Tubing with heating element |
796 |
790 |
$7K |
| A7034 |
Nasal application device |
159 |
159 |
$6K |
| K0738 |
Portable gas oxygen system |
221 |
220 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
87 |
82 |
$4K |
| K0739 |
Repair/svc dme non-oxygen eq |
258 |
244 |
$3K |
| K0001 |
Standard wheelchair |
153 |
148 |
$3K |
| A7046 |
Repl water chamber, pap dev |
273 |
270 |
$1K |
| E1028 |
W/c manual swingaway |
133 |
110 |
$577.20 |
| A7039 |
Filter, non disposable w pap |
68 |
68 |
$296.22 |
| A7003 |
Nebulizer administration set |
71 |
70 |
$116.92 |
| A7015 |
Aerosol mask used w nebulize |
42 |
42 |
$44.12 |