| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,494 |
3,254 |
$112K |
| E0431 |
Portable gaseous 02 |
3,670 |
2,147 |
$8K |
| E0260 |
Hosp bed semi-electr w/ matt |
374 |
214 |
$6K |
| E0601 |
Cont airway pressure device |
312 |
216 |
$5K |
| E0570 |
Nebulizer with compression |
578 |
447 |
$5K |
| K0001 |
Standard wheelchair |
881 |
590 |
$4K |
| A7030 |
Cpap full face mask |
143 |
79 |
$4K |
| A4604 |
Tubing with heating element |
90 |
65 |
$1K |
| A7038 |
Pos airway pressure filter |
641 |
447 |
$1K |
| A7031 |
Replacement facemask interfa |
86 |
54 |
$1K |
| A7035 |
Pos airway press headgear |
72 |
52 |
$693.43 |
| E0114 |
Crutch underarm pair no wood |
14 |
12 |
$345.07 |
| E0973 |
W/ch access det adj armrest |
118 |
40 |
$236.79 |
| A7037 |
Pos airway pressure tubing |
19 |
13 |
$131.23 |