| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,760 |
3,523 |
$285K |
| E0601 |
Cont airway pressure device |
4,305 |
2,717 |
$153K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,587 |
2,172 |
$67K |
| E0570 |
Nebulizer with compression |
3,125 |
2,130 |
$47K |
| E0431 |
Portable gaseous 02 |
3,803 |
2,429 |
$36K |
| A4554 |
Disposable underpads |
1,071 |
746 |
$35K |
| K0001 |
Standard wheelchair |
3,986 |
2,541 |
$32K |
| A7030 |
Cpap full face mask |
529 |
350 |
$31K |
| T4527 |
Adult size pull-on lg |
370 |
206 |
$22K |
| E0562 |
Humidifier heated used w pap |
1,291 |
883 |
$21K |
| T4526 |
Adult size pull-on med |
253 |
192 |
$16K |
| A7035 |
Pos airway press headgear |
1,191 |
800 |
$15K |
| A7034 |
Nasal application device |
179 |
119 |
$7K |
| A7038 |
Pos airway pressure filter |
2,210 |
1,442 |
$6K |
| A4604 |
Tubing with heating element |
441 |
305 |
$5K |
| A7037 |
Pos airway pressure tubing |
249 |
177 |
$5K |
| A7031 |
Replacement facemask interfa |
167 |
111 |
$4K |
| K0195 |
Elevating whlchair leg rests |
423 |
304 |
$3K |
| A7005 |
Nondisposable nebulizer set |
67 |
51 |
$943.40 |
| E0143 |
Walker folding wheeled w/o s |
16 |
13 |
$698.23 |
| A7046 |
Repl water chamber, pap dev |
67 |
50 |
$277.69 |
| A7003 |
Nebulizer administration set |
68 |
62 |
$141.44 |
| A7015 |
Aerosol mask used w nebulize |
13 |
13 |
$8.46 |