| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,911 |
5,910 |
$319K |
| E0570 |
Nebulizer with compression |
4,638 |
4,638 |
$138K |
| E0601 |
Cont airway pressure device |
2,519 |
2,519 |
$95K |
| E0431 |
Portable gaseous 02 |
5,078 |
5,074 |
$51K |
| K0001 |
Standard wheelchair |
2,478 |
2,477 |
$46K |
| A7030 |
Cpap full face mask |
544 |
544 |
$36K |
| E0562 |
Humidifier heated used w pap |
1,669 |
1,669 |
$30K |
| A7005 |
Nondisposable nebulizer set |
1,690 |
1,690 |
$26K |
| E0114 |
Crutch underarm pair no wood |
456 |
454 |
$22K |
| E0260 |
Hosp bed semi-electr w/ matt |
479 |
479 |
$14K |
| A7035 |
Pos airway press headgear |
508 |
508 |
$8K |
| L3908 |
Who cock-up nonmolde pre ots |
129 |
114 |
$5K |
| A7037 |
Pos airway pressure tubing |
286 |
286 |
$4K |
| E0143 |
Walker folding wheeled w/o s |
95 |
95 |
$4K |
| A7038 |
Pos airway pressure filter |
956 |
955 |
$3K |
| L4361 |
Pneuma/vac walk boot pre ots |
12 |
12 |
$2K |
| B4034 |
Enter feed supkit syr by day |
17 |
13 |
$1K |
| K0195 |
Elevating whlchair leg rests |
74 |
74 |
$691.68 |