| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
547 |
525 |
$26K |
| E0601 |
Cont airway pressure device |
620 |
552 |
$20K |
| E1028 |
W/c manual swingaway |
939 |
487 |
$13K |
| A4604 |
Tubing with heating element |
375 |
351 |
$11K |
| E0973 |
W/ch access det adj armrest |
632 |
313 |
$6K |
| E0431 |
Portable gaseous 02 |
341 |
333 |
$4K |
| A7038 |
Pos airway pressure filter |
356 |
340 |
$4K |
| K0003 |
Lightweight wheelchair |
74 |
63 |
$4K |
| E0570 |
Nebulizer with compression |
54 |
52 |
$3K |
| K0001 |
Standard wheelchair |
90 |
80 |
$3K |
| A7030 |
Cpap full face mask |
17 |
15 |
$2K |
| E0562 |
Humidifier heated used w pap |
12 |
12 |
$1K |
| A7034 |
Nasal application device |
28 |
24 |
$1K |
| A7035 |
Pos airway press headgear |
89 |
78 |
$1K |
| A7031 |
Replacement facemask interfa |
12 |
12 |
$469.01 |
| E0955 |
Cushioned headrest |
15 |
12 |
$431.39 |
| E0143 |
Walker folding wheeled w/o s |
12 |
12 |
$174.68 |
| A7046 |
Repl water chamber, pap dev |
16 |
13 |
$142.09 |
| A7003 |
Nebulizer administration set |
14 |
14 |
$19.34 |