| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,162 |
1,074 |
$20K |
| E0431 |
Portable gaseous 02 |
428 |
384 |
$2K |
| E1392 |
Portable oxygen concentrator |
210 |
206 |
$527.94 |
| E0601 |
Cont airway pressure device |
351 |
324 |
$344.83 |
| E0562 |
Humidifier heated used w pap |
157 |
140 |
$51.58 |
| E0260 |
Hosp bed semi-electr w/ matt |
28 |
28 |
$31.77 |
| A7037 |
Pos airway pressure tubing |
42 |
40 |
$24.23 |
| A7038 |
Pos airway pressure filter |
31 |
30 |
$16.80 |
| K0001 |
Standard wheelchair |
29 |
29 |
$3.15 |
| E0570 |
Nebulizer with compression |
112 |
110 |
$1.08 |
| E0483 |
Hi freq chest wall oscil sys |
12 |
12 |
$0.00 |
| E0466 |
Home vent non-invasive inter |
88 |
88 |
$0.00 |
| A7035 |
Pos airway press headgear |
26 |
24 |
$0.00 |
| A7039 |
Filter, non disposable w pap |
13 |
12 |
$0.00 |