| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,449 |
2,847 |
$114K |
| E0570 |
Nebulizer with compression |
1,617 |
1,222 |
$28K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,346 |
865 |
$25K |
| E0601 |
Cont airway pressure device |
342 |
197 |
$11K |
| K0001 |
Standard wheelchair |
1,381 |
986 |
$9K |
| E0431 |
Portable gaseous 02 |
1,621 |
1,064 |
$8K |
| E1140 |
Wheelchair standard detach a |
202 |
115 |
$6K |
| K0195 |
Elevating whlchair leg rests |
633 |
406 |
$3K |
| E0562 |
Humidifier heated used w pap |
119 |
87 |
$1K |
| E1392 |
Portable oxygen concentrator |
117 |
80 |
$1K |
| A7003 |
Nebulizer administration set |
759 |
585 |
$976.81 |
| E0143 |
Walker folding wheeled w/o s |
12 |
12 |
$321.16 |
| A7035 |
Pos airway press headgear |
14 |
12 |
$162.49 |
| E0156 |
Walker seat attachment |
57 |
38 |
$149.17 |
| A7037 |
Pos airway pressure tubing |
15 |
13 |
$148.50 |
| A7039 |
Filter, non disposable w pap |
15 |
13 |
$61.11 |
| A7013 |
Disposable compressor filter |
179 |
148 |
$54.83 |