| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
7,611 |
6,110 |
$191K |
| E0601 |
Cont airway pressure device |
1,674 |
1,407 |
$35K |
| E0431 |
Portable gaseous 02 |
5,056 |
4,072 |
$22K |
| E0562 |
Humidifier heated used w pap |
2,111 |
1,785 |
$12K |
| A7030 |
Cpap full face mask |
295 |
195 |
$7K |
| E0261 |
Hosp bed semi-electr w/o mat |
372 |
333 |
$7K |
| A7037 |
Pos airway pressure tubing |
892 |
654 |
$4K |
| E0570 |
Nebulizer with compression |
975 |
731 |
$3K |
| A7038 |
Pos airway pressure filter |
1,347 |
923 |
$3K |
| E1392 |
Portable oxygen concentrator |
183 |
161 |
$2K |
| A7035 |
Pos airway press headgear |
150 |
111 |
$976.66 |
| A7031 |
Replacement facemask interfa |
45 |
40 |
$309.09 |
| K0001 |
Standard wheelchair |
55 |
48 |
$295.84 |
| A7034 |
Nasal application device |
14 |
13 |
$244.70 |
| A7039 |
Filter, non disposable w pap |
74 |
63 |
$134.94 |