| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,826 |
1,075 |
$63K |
| E0570 |
Nebulizer with compression |
1,049 |
693 |
$50K |
| A4627 |
Spacer bag/reservoir |
283 |
230 |
$12K |
| E0431 |
Portable gaseous 02 |
1,490 |
896 |
$9K |
| A7030 |
Cpap full face mask |
75 |
59 |
$7K |
| A7005 |
Nondisposable nebulizer set |
292 |
225 |
$5K |
| A7031 |
Replacement facemask interfa |
138 |
98 |
$4K |
| E0601 |
Cont airway pressure device |
93 |
72 |
$4K |
| A7037 |
Pos airway pressure tubing |
106 |
85 |
$2K |
| K0001 |
Standard wheelchair |
171 |
102 |
$1K |
| A4253 |
Blood glucose/reagent strips |
467 |
332 |
$1K |
| A7038 |
Pos airway pressure filter |
246 |
175 |
$853.25 |
| A7034 |
Nasal application device |
35 |
13 |
$826.37 |
| A4554 |
Disposable underpads |
12 |
12 |
$810.00 |
| A7035 |
Pos airway press headgear |
49 |
42 |
$718.66 |
| E0260 |
Hosp bed semi-electr w/ matt |
43 |
24 |
$499.28 |
| A7046 |
Repl water chamber, pap dev |
48 |
39 |
$458.77 |
| A7015 |
Aerosol mask used w nebulize |
226 |
182 |
$306.86 |
| A7003 |
Nebulizer administration set |
13 |
13 |
$59.80 |
| A4259 |
Lancets per box |
212 |
156 |
$51.83 |