| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,760 |
3,986 |
$143K |
| Q0513 |
Disp fee inhal drugs/30 days |
17,011 |
15,497 |
$83K |
| E0601 |
Cont airway pressure device |
2,805 |
2,480 |
$83K |
| J7626 |
Budesonide non-comp unit |
2,497 |
2,194 |
$58K |
| E0562 |
Humidifier heated used w pap |
2,040 |
1,787 |
$32K |
| J7620 |
Albuterol ipratrop non-comp |
8,498 |
7,785 |
$28K |
| A7030 |
Cpap full face mask |
774 |
616 |
$26K |
| A7031 |
Replacement facemask interfa |
1,172 |
963 |
$22K |
| J7613 |
Albuterol non-comp unit |
6,630 |
6,028 |
$19K |
| E0431 |
Portable gaseous 02 |
1,447 |
1,216 |
$11K |
| E0470 |
Rad w/o backup non-inv intfc |
287 |
219 |
$9K |
| A4604 |
Tubing with heating element |
473 |
374 |
$7K |
| A7035 |
Pos airway press headgear |
696 |
568 |
$7K |
| A7038 |
Pos airway pressure filter |
2,236 |
1,807 |
$5K |
| J7606 |
Formoterol fumarate, inh |
206 |
173 |
$4K |
| E1392 |
Portable oxygen concentrator |
283 |
220 |
$4K |
| A7032 |
Replacement nasal cushion |
158 |
139 |
$3K |
| G0333 |
Dispense fee initial 30 day |
476 |
418 |
$3K |
| A7037 |
Pos airway pressure tubing |
320 |
272 |
$2K |
| J7677 |
Revefenacin inh non-com 1mcg |
31 |
26 |
$2K |
| A7005 |
Nondisposable nebulizer set |
1,090 |
1,015 |
$2K |
| J7605 |
Arformoterol non-comp unit |
91 |
80 |
$2K |
| A7046 |
Repl water chamber, pap dev |
194 |
160 |
$1K |
| A7003 |
Nebulizer administration set |
1,397 |
1,294 |
$755.83 |
| A7034 |
Nasal application device |
25 |
16 |
$415.27 |
| J7644 |
Ipratropium bromide non-comp |
125 |
98 |
$140.22 |
| A7015 |
Aerosol mask used w nebulize |
257 |
230 |
$43.12 |