| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,684 |
1,674 |
$142K |
| E0601 |
Cont airway pressure device |
1,549 |
1,533 |
$69K |
| A7030 |
Cpap full face mask |
512 |
508 |
$30K |
| E0570 |
Nebulizer with compression |
809 |
803 |
$30K |
| E0431 |
Portable gaseous 02 |
837 |
830 |
$18K |
| E0562 |
Humidifier heated used w pap |
1,488 |
1,470 |
$12K |
| A7031 |
Replacement facemask interfa |
466 |
464 |
$11K |
| A7035 |
Pos airway press headgear |
514 |
510 |
$10K |
| K0001 |
Standard wheelchair |
314 |
314 |
$5K |
| K0738 |
Portable gas oxygen system |
570 |
559 |
$5K |
| A7037 |
Pos airway pressure tubing |
162 |
162 |
$4K |
| E0114 |
Crutch underarm pair no wood |
84 |
83 |
$3K |
| A7038 |
Pos airway pressure filter |
615 |
612 |
$2K |
| A4604 |
Tubing with heating element |
195 |
193 |
$2K |
| A7003 |
Nebulizer administration set |
334 |
330 |
$1K |
| A7034 |
Nasal application device |
26 |
26 |
$861.93 |
| A7046 |
Repl water chamber, pap dev |
182 |
182 |
$847.01 |
| E0260 |
Hosp bed semi-electr w/ matt |
24 |
24 |
$688.66 |