| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,564 |
11,630 |
$498K |
| E0431 |
Portable gaseous 02 |
8,350 |
7,113 |
$96K |
| E0601 |
Cont airway pressure device |
790 |
624 |
$20K |
| K0001 |
Standard wheelchair |
439 |
379 |
$6K |
| E0570 |
Nebulizer with compression |
794 |
713 |
$5K |
| A7030 |
Cpap full face mask |
257 |
168 |
$4K |
| A7035 |
Pos airway press headgear |
333 |
231 |
$2K |
| A7037 |
Pos airway pressure tubing |
414 |
265 |
$2K |
| A7038 |
Pos airway pressure filter |
898 |
657 |
$2K |
| A7031 |
Replacement facemask interfa |
211 |
104 |
$1K |
| E0260 |
Hosp bed semi-electr w/ matt |
192 |
142 |
$1K |
| E0250 |
Hosp bed fixed ht w/ mattres |
77 |
57 |
$781.68 |
| A7039 |
Filter, non disposable w pap |
131 |
87 |
$259.66 |
| E0443 |
Portable 02 contents, gas |
12 |
12 |
$197.43 |
| A7034 |
Nasal application device |
21 |
12 |
$120.34 |
| A7005 |
Nondisposable nebulizer set |
13 |
12 |
$106.74 |