| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,191 |
13,142 |
$633K |
| E0431 |
Portable gaseous 02 |
5,528 |
5,515 |
$46K |
| A7030 |
Cpap full face mask |
977 |
969 |
$37K |
| A7031 |
Replacement facemask interfa |
1,246 |
1,239 |
$34K |
| E0601 |
Cont airway pressure device |
648 |
645 |
$18K |
| E0570 |
Nebulizer with compression |
2,587 |
2,587 |
$15K |
| E1392 |
Portable oxygen concentrator |
1,241 |
1,227 |
$14K |
| A4604 |
Tubing with heating element |
893 |
880 |
$7K |
| E0562 |
Humidifier heated used w pap |
1,356 |
1,349 |
$7K |
| A7035 |
Pos airway press headgear |
719 |
711 |
$4K |
| A7038 |
Pos airway pressure filter |
2,144 |
2,122 |
$4K |
| E0470 |
Rad w/o backup non-inv intfc |
12 |
12 |
$993.54 |
| A7003 |
Nebulizer administration set |
842 |
807 |
$799.05 |
| A7037 |
Pos airway pressure tubing |
65 |
65 |
$602.91 |
| A7046 |
Repl water chamber, pap dev |
252 |
250 |
$440.73 |
| E0443 |
Portable 02 contents, gas |
75 |
75 |
$339.42 |
| A7005 |
Nondisposable nebulizer set |
38 |
38 |
$261.48 |
| A7015 |
Aerosol mask used w nebulize |
12 |
12 |
$0.42 |