| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,568 |
6,596 |
$480K |
| E0601 |
Cont airway pressure device |
4,172 |
3,410 |
$160K |
| E0570 |
Nebulizer with compression |
1,710 |
1,378 |
$151K |
| A7030 |
Cpap full face mask |
1,414 |
1,136 |
$106K |
| A7031 |
Replacement facemask interfa |
1,470 |
1,173 |
$50K |
| E0431 |
Portable gaseous 02 |
4,270 |
3,348 |
$47K |
| E0562 |
Humidifier heated used w pap |
1,549 |
1,294 |
$41K |
| A7005 |
Nondisposable nebulizer set |
2,103 |
1,716 |
$34K |
| A4604 |
Tubing with heating element |
880 |
717 |
$27K |
| A7035 |
Pos airway press headgear |
991 |
785 |
$15K |
| E1392 |
Portable oxygen concentrator |
731 |
526 |
$13K |
| E1028 |
W/c manual swingaway |
682 |
364 |
$12K |
| A7038 |
Pos airway pressure filter |
2,389 |
1,936 |
$10K |
| A6530 |
Compression stocking bk18-30 |
200 |
78 |
$5K |
| A7037 |
Pos airway pressure tubing |
228 |
178 |
$3K |
| A7039 |
Filter, non disposable w pap |
642 |
506 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
752 |
629 |
$804.22 |
| K0739 |
Repair/svc dme non-oxygen eq |
23 |
14 |
$338.25 |
| A7046 |
Repl water chamber, pap dev |
29 |
25 |
$133.68 |