| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,398 |
4,326 |
$180K |
| E0601 |
Cont airway pressure device |
1,776 |
1,449 |
$36K |
| E0431 |
Portable gaseous 02 |
2,762 |
2,260 |
$18K |
| E1392 |
Portable oxygen concentrator |
1,274 |
1,070 |
$9K |
| E0260 |
Hosp bed semi-electr w/ matt |
346 |
235 |
$6K |
| E0570 |
Nebulizer with compression |
2,145 |
1,701 |
$6K |
| E0470 |
Rad w/o backup non-inv intfc |
66 |
61 |
$5K |
| E0562 |
Humidifier heated used w pap |
686 |
640 |
$3K |
| K0001 |
Standard wheelchair |
272 |
218 |
$1K |
| A7031 |
Replacement facemask interfa |
553 |
457 |
$599.65 |
| A7030 |
Cpap full face mask |
314 |
258 |
$580.04 |
| A7038 |
Pos airway pressure filter |
1,117 |
915 |
$522.93 |
| A4604 |
Tubing with heating element |
643 |
519 |
$125.11 |
| A7046 |
Repl water chamber, pap dev |
65 |
54 |
$0.26 |
| A7032 |
Replacement nasal cushion |
43 |
28 |
$0.00 |
| A7034 |
Nasal application device |
76 |
56 |
$0.00 |
| A7035 |
Pos airway press headgear |
170 |
139 |
$0.00 |