| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1028 |
W/c manual swingaway |
556 |
381 |
$84K |
| E1390 |
Oxygen concentrator |
1,641 |
1,405 |
$34K |
| E0601 |
Cont airway pressure device |
1,328 |
1,103 |
$34K |
| E1012 |
Ctr mount pwr elev leg rest |
31 |
27 |
$20K |
| E0431 |
Portable gaseous 02 |
677 |
568 |
$9K |
| E2361 |
22nf sealed leadacid battery |
64 |
55 |
$7K |
| A7030 |
Cpap full face mask |
132 |
107 |
$3K |
| E0562 |
Humidifier heated used w pap |
83 |
83 |
$2K |
| E0955 |
Cushioned headrest |
97 |
89 |
$2K |
| A7038 |
Pos airway pressure filter |
369 |
288 |
$2K |
| K0040 |
Adjustable angle footplate |
89 |
81 |
$2K |
| A7035 |
Pos airway press headgear |
78 |
66 |
$1K |
| A4927 |
Non-sterile gloves |
38 |
36 |
$936.74 |
| E0570 |
Nebulizer with compression |
39 |
38 |
$850.63 |
| E0973 |
W/ch access det adj armrest |
14 |
13 |
$126.90 |
| E1007 |
Pwr seat combo w/shear |
30 |
27 |
$71.65 |
| A4604 |
Tubing with heating element |
52 |
37 |
$65.55 |
| A7031 |
Replacement facemask interfa |
21 |
14 |
$61.81 |
| E2313 |
Pwc harness, expand control |
32 |
29 |
$0.00 |
| E2377 |
Expandable controller, initl |
30 |
27 |
$0.00 |
| E2311 |
Electro connect btw 2 sys |
32 |
28 |
$0.00 |