| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
17,807 |
13,800 |
$588K |
| E0601 |
Cont airway pressure device |
2,576 |
2,160 |
$97K |
| A7030 |
Cpap full face mask |
1,697 |
1,354 |
$90K |
| E0431 |
Portable gaseous 02 |
10,643 |
8,169 |
$74K |
| E0470 |
Rad w/o backup non-inv intfc |
660 |
491 |
$40K |
| E1392 |
Portable oxygen concentrator |
3,822 |
3,069 |
$38K |
| E0562 |
Humidifier heated used w pap |
3,594 |
2,902 |
$37K |
| A7031 |
Replacement facemask interfa |
1,406 |
1,127 |
$34K |
| E1130 |
Whlchr stand fxd arm ft rest |
951 |
903 |
$22K |
| A7037 |
Pos airway pressure tubing |
2,127 |
1,652 |
$18K |
| A7035 |
Pos airway press headgear |
1,444 |
1,126 |
$15K |
| E0570 |
Nebulizer with compression |
2,812 |
1,934 |
$15K |
| E0250 |
Hosp bed fixed ht w/ mattres |
981 |
612 |
$14K |
| E0260 |
Hosp bed semi-electr w/ matt |
769 |
545 |
$10K |
| A7038 |
Pos airway pressure filter |
2,553 |
1,981 |
$8K |
| A7034 |
Nasal application device |
117 |
89 |
$4K |
| A7039 |
Filter, non disposable w pap |
985 |
763 |
$4K |
| A4604 |
Tubing with heating element |
139 |
123 |
$3K |
| A7046 |
Repl water chamber, pap dev |
368 |
298 |
$3K |
| K0001 |
Standard wheelchair |
254 |
204 |
$396.99 |