| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
9,938 |
8,957 |
$262K |
| E0466 |
Home vent non-invasive inter |
685 |
604 |
$177K |
| E0431 |
Portable gaseous 02 |
6,515 |
5,931 |
$60K |
| E0601 |
Cont airway pressure device |
1,466 |
1,310 |
$40K |
| E0470 |
Rad w/o backup non-inv intfc |
246 |
233 |
$21K |
| K0001 |
Standard wheelchair |
537 |
477 |
$14K |
| E0260 |
Hosp bed semi-electr w/ matt |
409 |
370 |
$14K |
| A7030 |
Cpap full face mask |
517 |
448 |
$13K |
| A7035 |
Pos airway press headgear |
693 |
589 |
$5K |
| A7031 |
Replacement facemask interfa |
437 |
374 |
$4K |
| E0973 |
W/ch access det adj armrest |
917 |
415 |
$4K |
| A4604 |
Tubing with heating element |
413 |
358 |
$4K |
| E0562 |
Humidifier heated used w pap |
87 |
79 |
$3K |
| E0570 |
Nebulizer with compression |
443 |
406 |
$3K |
| A7038 |
Pos airway pressure filter |
1,424 |
1,188 |
$2K |
| A7034 |
Nasal application device |
140 |
122 |
$2K |
| A7037 |
Pos airway pressure tubing |
157 |
148 |
$885.85 |
| E0951 |
Loop heel |
533 |
251 |
$588.65 |
| A7046 |
Repl water chamber, pap dev |
68 |
61 |
$58.06 |
| A7039 |
Filter, non disposable w pap |
16 |
12 |
$21.53 |