| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,587 |
6,716 |
$383K |
| E0601 |
Cont airway pressure device |
3,093 |
1,934 |
$63K |
| E0431 |
Portable gaseous 02 |
7,892 |
5,074 |
$52K |
| A7030 |
Cpap full face mask |
1,448 |
957 |
$51K |
| A7031 |
Replacement facemask interfa |
1,550 |
1,003 |
$30K |
| E0562 |
Humidifier heated used w pap |
3,683 |
2,344 |
$22K |
| A7035 |
Pos airway press headgear |
1,271 |
854 |
$10K |
| A7038 |
Pos airway pressure filter |
3,142 |
2,119 |
$8K |
| A4604 |
Tubing with heating element |
841 |
599 |
$7K |
| K0001 |
Standard wheelchair |
561 |
369 |
$6K |
| A7037 |
Pos airway pressure tubing |
548 |
374 |
$6K |
| E0570 |
Nebulizer with compression |
988 |
611 |
$4K |
| A7034 |
Nasal application device |
157 |
100 |
$4K |
| E0143 |
Walker folding wheeled w/o s |
67 |
49 |
$2K |
| A7046 |
Repl water chamber, pap dev |
250 |
183 |
$618.22 |
| A7032 |
Replacement nasal cushion |
24 |
14 |
$367.58 |
| E0260 |
Hosp bed semi-electr w/ matt |
18 |
12 |
$180.55 |
| A7039 |
Filter, non disposable w pap |
44 |
28 |
$120.05 |