| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,143 |
3,320 |
$130K |
| E0601 |
Cont airway pressure device |
1,494 |
1,239 |
$60K |
| K0001 |
Standard wheelchair |
1,191 |
931 |
$9K |
| E0431 |
Portable gaseous 02 |
2,787 |
2,212 |
$8K |
| E0562 |
Humidifier heated used w pap |
1,021 |
865 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
187 |
140 |
$3K |
| E0570 |
Nebulizer with compression |
744 |
589 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
53 |
40 |
$870.74 |
| E1392 |
Portable oxygen concentrator |
222 |
180 |
$340.88 |
| A7030 |
Cpap full face mask |
35 |
27 |
$50.67 |
| A7037 |
Pos airway pressure tubing |
62 |
45 |
$13.43 |
| A7031 |
Replacement facemask interfa |
38 |
29 |
$6.19 |
| A7035 |
Pos airway press headgear |
47 |
38 |
$4.36 |
| A7038 |
Pos airway pressure filter |
210 |
155 |
$2.27 |