| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
1,542 |
1,341 |
$253K |
| E1390 |
Oxygen concentrator |
3,390 |
2,980 |
$116K |
| E0570 |
Nebulizer with compression |
1,740 |
1,530 |
$101K |
| E0601 |
Cont airway pressure device |
3,368 |
2,932 |
$100K |
| A4604 |
Tubing with heating element |
2,790 |
2,395 |
$62K |
| A7030 |
Cpap full face mask |
1,464 |
1,257 |
$55K |
| A7031 |
Replacement facemask interfa |
2,363 |
2,006 |
$49K |
| E0470 |
Rad w/o backup non-inv intfc |
651 |
580 |
$46K |
| A7034 |
Nasal application device |
1,182 |
1,020 |
$37K |
| E0562 |
Humidifier heated used w pap |
3,454 |
2,955 |
$35K |
| A7035 |
Pos airway press headgear |
2,245 |
1,927 |
$23K |
| K0001 |
Standard wheelchair |
2,461 |
1,991 |
$22K |
| E0431 |
Portable gaseous 02 |
1,768 |
1,588 |
$14K |
| A7038 |
Pos airway pressure filter |
4,087 |
3,301 |
$10K |
| A7005 |
Nondisposable nebulizer set |
695 |
657 |
$7K |
| A7046 |
Repl water chamber, pap dev |
898 |
767 |
$6K |
| A7032 |
Replacement nasal cushion |
233 |
209 |
$6K |
| A7033 |
Replacement nasal pillows |
306 |
263 |
$5K |
| E0260 |
Hosp bed semi-electr w/ matt |
365 |
302 |
$4K |
| A7037 |
Pos airway pressure tubing |
440 |
381 |
$3K |
| A7039 |
Filter, non disposable w pap |
843 |
732 |
$3K |
| A7003 |
Nebulizer administration set |
365 |
354 |
$70.69 |