| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,031 |
9,929 |
$1.07M |
| E0601 |
Cont airway pressure device |
2,104 |
2,096 |
$127K |
| E0431 |
Portable gaseous 02 |
5,857 |
5,713 |
$114K |
| E0570 |
Nebulizer with compression |
4,971 |
4,931 |
$81K |
| A7030 |
Cpap full face mask |
524 |
521 |
$57K |
| A7032 |
Replacement nasal cushion |
835 |
823 |
$49K |
| A7031 |
Replacement facemask interfa |
778 |
774 |
$42K |
| E0603 |
Electric breast pump |
325 |
325 |
$41K |
| A7034 |
Nasal application device |
535 |
531 |
$33K |
| A7038 |
Pos airway pressure filter |
2,986 |
2,943 |
$24K |
| E1392 |
Portable oxygen concentrator |
585 |
578 |
$24K |
| A7035 |
Pos airway press headgear |
833 |
819 |
$17K |
| A7037 |
Pos airway pressure tubing |
783 |
774 |
$15K |
| A4604 |
Tubing with heating element |
255 |
253 |
$10K |
| K0001 |
Standard wheelchair |
381 |
379 |
$8K |
| E0562 |
Humidifier heated used w pap |
402 |
402 |
$8K |
| A9901 |
Delivery/set up/dispensing |
990 |
902 |
$7K |
| A7046 |
Repl water chamber, pap dev |
448 |
444 |
$5K |
| E0424 |
Stationary compressed gas 02 |
24 |
24 |
$3K |
| E0260 |
Hosp bed semi-electr w/ matt |
26 |
26 |
$1K |
| A7004 |
Disposable nebulizer sml vol |
569 |
561 |
$688.92 |
| E0143 |
Walker folding wheeled w/o s |
12 |
12 |
$446.85 |
| A7015 |
Aerosol mask used w nebulize |
222 |
221 |
$333.05 |
| A4927 |
Non-sterile gloves |
14 |
13 |
$105.56 |
| A7039 |
Filter, non disposable w pap |
12 |
12 |
$85.52 |