| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
283 |
265 |
$14K |
| A7032 |
Replacement nasal cushion |
148 |
139 |
$14K |
| A7030 |
Cpap full face mask |
168 |
156 |
$14K |
| A7031 |
Replacement facemask interfa |
165 |
153 |
$14K |
| A4604 |
Tubing with heating element |
380 |
357 |
$11K |
| E0601 |
Cont airway pressure device |
137 |
124 |
$11K |
| A7034 |
Nasal application device |
212 |
200 |
$11K |
| E0470 |
Rad w/o backup non-inv intfc |
69 |
59 |
$10K |
| A7038 |
Pos airway pressure filter |
412 |
387 |
$5K |
| E0562 |
Humidifier heated used w pap |
172 |
158 |
$4K |
| A7035 |
Pos airway press headgear |
228 |
212 |
$4K |
| T4541 |
Large disposable underpad |
108 |
105 |
$2K |
| E0570 |
Nebulizer with compression |
144 |
133 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
87 |
75 |
$2K |
| A7033 |
Replacement nasal pillows |
41 |
38 |
$2K |
| K0001 |
Standard wheelchair |
105 |
85 |
$2K |
| A7046 |
Repl water chamber, pap dev |
168 |
156 |
$1K |
| E0431 |
Portable gaseous 02 |
116 |
106 |
$899.30 |
| A4927 |
Non-sterile gloves |
42 |
32 |
$590.24 |
| A4520 |
Incontinence garment anytype |
23 |
13 |
$0.00 |