| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,861 |
7,495 |
$484K |
| E0570 |
Nebulizer with compression |
3,424 |
2,854 |
$138K |
| E0431 |
Portable gaseous 02 |
5,782 |
4,926 |
$58K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,209 |
1,730 |
$57K |
| E0601 |
Cont airway pressure device |
746 |
683 |
$27K |
| K0001 |
Standard wheelchair |
1,971 |
1,627 |
$20K |
| E0562 |
Humidifier heated used w pap |
627 |
555 |
$13K |
| A7003 |
Nebulizer administration set |
2,961 |
2,669 |
$8K |
| A7030 |
Cpap full face mask |
76 |
65 |
$4K |
| A7015 |
Aerosol mask used w nebulize |
2,612 |
2,356 |
$3K |
| A7038 |
Pos airway pressure filter |
732 |
628 |
$2K |
| E1392 |
Portable oxygen concentrator |
123 |
110 |
$2K |
| A5500 |
Diab shoe for density insert |
40 |
25 |
$2K |
| A7037 |
Pos airway pressure tubing |
77 |
68 |
$936.44 |
| A5512 |
Multi den insert direct form |
26 |
12 |
$716.72 |
| A7035 |
Pos airway press headgear |
28 |
27 |
$393.73 |