| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,897 |
1,663 |
$148K |
| E0601 |
Cont airway pressure device |
2,304 |
2,120 |
$113K |
| E0562 |
Humidifier heated used w pap |
2,184 |
2,022 |
$40K |
| E0570 |
Nebulizer with compression |
860 |
820 |
$29K |
| K0738 |
Portable gas oxygen system |
1,191 |
1,005 |
$26K |
| A4604 |
Tubing with heating element |
890 |
813 |
$25K |
| A7035 |
Pos airway press headgear |
779 |
722 |
$16K |
| A7034 |
Nasal application device |
225 |
218 |
$14K |
| A7030 |
Cpap full face mask |
161 |
150 |
$13K |
| A7038 |
Pos airway pressure filter |
1,770 |
1,601 |
$8K |
| T4541 |
Large disposable underpad |
132 |
121 |
$8K |
| A7032 |
Replacement nasal cushion |
144 |
131 |
$5K |
| A7031 |
Replacement facemask interfa |
216 |
184 |
$4K |
| A7046 |
Repl water chamber, pap dev |
288 |
275 |
$3K |
| A4670 |
Automatic bp monitor, dial |
38 |
37 |
$2K |
| A4385 |
Ost skn barrier sld ext wear |
25 |
25 |
$2K |
| T4525 |
Adult size pull-on sm |
13 |
13 |
$1K |
| K0001 |
Standard wheelchair |
36 |
25 |
$602.22 |