| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,895 |
4,035 |
$227K |
| E0570 |
Nebulizer with compression |
4,526 |
3,977 |
$125K |
| E0601 |
Cont airway pressure device |
1,332 |
1,196 |
$88K |
| A7030 |
Cpap full face mask |
572 |
531 |
$48K |
| A7005 |
Nondisposable nebulizer set |
2,453 |
2,299 |
$35K |
| K0001 |
Standard wheelchair |
2,969 |
2,536 |
$30K |
| E0260 |
Hosp bed semi-electr w/ matt |
906 |
778 |
$26K |
| A7037 |
Pos airway pressure tubing |
932 |
862 |
$20K |
| A7038 |
Pos airway pressure filter |
956 |
879 |
$5K |
| A7035 |
Pos airway press headgear |
243 |
227 |
$5K |
| E0562 |
Humidifier heated used w pap |
106 |
103 |
$4K |
| E0431 |
Portable gaseous 02 |
2,717 |
2,187 |
$4K |
| A5500 |
Diab shoe for density insert |
66 |
42 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
2,469 |
2,308 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
59 |
52 |
$2K |
| A5512 |
Multi den insert direct form |
64 |
41 |
$1K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
14 |
12 |
$650.14 |
| E0971 |
Wheelchair anti-tipping devi |
42 |
25 |
$333.97 |
| E0951 |
Loop heel |
40 |
24 |
$113.52 |