| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,554 |
1,482 |
$81K |
| E0601 |
Cont airway pressure device |
1,761 |
1,649 |
$80K |
| E0570 |
Nebulizer with compression |
2,294 |
2,088 |
$60K |
| E0562 |
Humidifier heated used w pap |
1,801 |
1,665 |
$23K |
| A7030 |
Cpap full face mask |
406 |
344 |
$21K |
| A7037 |
Pos airway pressure tubing |
1,555 |
1,411 |
$17K |
| K0001 |
Standard wheelchair |
963 |
871 |
$11K |
| A4253 |
Blood glucose/reagent strips |
681 |
586 |
$9K |
| A7038 |
Pos airway pressure filter |
2,071 |
1,781 |
$9K |
| A7035 |
Pos airway press headgear |
836 |
755 |
$7K |
| A7031 |
Replacement facemask interfa |
209 |
144 |
$6K |
| E0431 |
Portable gaseous 02 |
285 |
268 |
$3K |
| A7034 |
Nasal application device |
69 |
67 |
$3K |
| A7039 |
Filter, non disposable w pap |
363 |
351 |
$2K |
| E0250 |
Hosp bed fixed ht w/ mattres |
122 |
102 |
$2K |
| A7003 |
Nebulizer administration set |
842 |
667 |
$2K |
| A4259 |
Lancets per box |
432 |
361 |
$757.25 |
| A7046 |
Repl water chamber, pap dev |
40 |
27 |
$228.54 |
| A4258 |
Lancet device each |
12 |
12 |
$65.80 |