| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,285 |
5,048 |
$286K |
| E0601 |
Cont airway pressure device |
6,230 |
5,387 |
$265K |
| E0470 |
Rad w/o backup non-inv intfc |
547 |
456 |
$49K |
| E0562 |
Humidifier heated used w pap |
3,828 |
3,407 |
$19K |
| E0431 |
Portable gaseous 02 |
1,682 |
1,411 |
$12K |
| E1392 |
Portable oxygen concentrator |
2,276 |
1,763 |
$10K |
| E0570 |
Nebulizer with compression |
1,182 |
990 |
$5K |
| A7037 |
Pos airway pressure tubing |
1,258 |
1,029 |
$3K |
| A7038 |
Pos airway pressure filter |
2,759 |
2,277 |
$2K |
| A7030 |
Cpap full face mask |
981 |
811 |
$1K |
| A7031 |
Replacement facemask interfa |
1,323 |
1,082 |
$1K |
| A7035 |
Pos airway press headgear |
936 |
764 |
$934.27 |
| A7032 |
Replacement nasal cushion |
523 |
427 |
$648.22 |
| A7046 |
Repl water chamber, pap dev |
582 |
487 |
$565.64 |
| A7034 |
Nasal application device |
608 |
502 |
$552.76 |
| E0260 |
Hosp bed semi-electr w/ matt |
28 |
24 |
$409.66 |
| K0001 |
Standard wheelchair |
18 |
13 |
$248.45 |
| A4604 |
Tubing with heating element |
614 |
501 |
$205.18 |
| A7033 |
Replacement nasal pillows |
135 |
110 |
$186.46 |
| A7039 |
Filter, non disposable w pap |
410 |
322 |
$76.20 |
| K0738 |
Portable gas oxygen system |
60 |
53 |
$0.00 |
| A7036 |
Pos airway press chinstrap |
15 |
13 |
$0.00 |