| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,090 |
5,028 |
$407K |
| K0001 |
Standard wheelchair |
2,353 |
2,295 |
$74K |
| E0601 |
Cont airway pressure device |
647 |
645 |
$49K |
| E0431 |
Portable gaseous 02 |
3,589 |
3,545 |
$46K |
| E0143 |
Walker folding wheeled w/o s |
835 |
824 |
$36K |
| E0630 |
Patient lift hydraulic |
709 |
706 |
$18K |
| E0260 |
Hosp bed semi-electr w/ matt |
973 |
971 |
$13K |
| E0570 |
Nebulizer with compression |
1,078 |
1,070 |
$12K |
| E0562 |
Humidifier heated used w pap |
353 |
353 |
$11K |
| A4604 |
Tubing with heating element |
204 |
204 |
$5K |
| E1392 |
Portable oxygen concentrator |
374 |
371 |
$5K |
| A7038 |
Pos airway pressure filter |
415 |
412 |
$3K |
| K0003 |
Lightweight wheelchair |
49 |
49 |
$2K |
| K0195 |
Elevating whlchair leg rests |
135 |
124 |
$2K |
| E0295 |
Hosp bed semi-elect w/o matt |
14 |
13 |
$2K |
| A7035 |
Pos airway press headgear |
86 |
86 |
$1K |
| A7034 |
Nasal application device |
12 |
12 |
$707.45 |
| E0272 |
Mattress foam rubber |
39 |
39 |
$600.66 |
| A7030 |
Cpap full face mask |
12 |
12 |
$351.33 |
| E0305 |
Rails bed side half length |
25 |
25 |
$340.02 |
| A7046 |
Repl water chamber, pap dev |
12 |
12 |
$91.43 |