| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
68,976 |
43,510 |
$2.05M |
| E0466 |
Home vent non-invasive inter |
2,452 |
1,424 |
$448K |
| A7030 |
Cpap full face mask |
4,993 |
3,790 |
$242K |
| E0601 |
Cont airway pressure device |
6,060 |
4,385 |
$215K |
| E0431 |
Portable gaseous 02 |
38,464 |
24,551 |
$206K |
| B4035 |
Enteral feed supp pump per d |
3,034 |
1,570 |
$151K |
| A7031 |
Replacement facemask interfa |
5,147 |
4,088 |
$137K |
| A4604 |
Tubing with heating element |
4,137 |
3,450 |
$111K |
| E1392 |
Portable oxygen concentrator |
11,492 |
6,956 |
$105K |
| A7034 |
Nasal application device |
3,124 |
2,405 |
$98K |
| E0570 |
Nebulizer with compression |
13,308 |
8,695 |
$98K |
| A7035 |
Pos airway press headgear |
5,703 |
4,430 |
$66K |
| E0562 |
Humidifier heated used w pap |
6,690 |
4,878 |
$59K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
568 |
512 |
$53K |
| A7032 |
Replacement nasal cushion |
1,845 |
1,518 |
$52K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,306 |
1,542 |
$47K |
| A7037 |
Pos airway pressure tubing |
5,264 |
4,014 |
$44K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,405 |
916 |
$36K |
| A7038 |
Pos airway pressure filter |
17,751 |
12,219 |
$35K |
| K0001 |
Standard wheelchair |
2,955 |
2,023 |
$29K |
| A7046 |
Repl water chamber, pap dev |
3,553 |
2,925 |
$28K |
| A7033 |
Replacement nasal pillows |
991 |
786 |
$17K |
| E0143 |
Walker folding wheeled w/o s |
298 |
231 |
$7K |
| B4034 |
Enter feed supkit syr by day |
212 |
132 |
$5K |
| E0470 |
Rad w/o backup non-inv intfc |
65 |
39 |
$4K |
| E0439 |
Stationary liquid 02 |
181 |
130 |
$3K |
| A7005 |
Nondisposable nebulizer set |
793 |
572 |
$3K |
| A7039 |
Filter, non disposable w pap |
590 |
471 |
$3K |
| A7003 |
Nebulizer administration set |
3,774 |
2,690 |
$2K |
| K0195 |
Elevating whlchair leg rests |
847 |
580 |
$2K |
| E0443 |
Portable 02 contents, gas |
838 |
682 |
$2K |
| E0156 |
Walker seat attachment |
66 |
43 |
$424.65 |
| B4154 |
Ef spec metabolic noninherit |
19 |
12 |
$337.13 |
| E0434 |
Portable liquid 02 |
95 |
66 |
$303.57 |