| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
1,654 |
1,446 |
$98K |
| E1390 |
Oxygen concentrator |
662 |
587 |
$58K |
| E0603 |
Electric breast pump |
204 |
148 |
$48K |
| E0260 |
Hosp bed semi-electr w/ matt |
498 |
487 |
$23K |
| A7031 |
Replacement facemask interfa |
610 |
578 |
$20K |
| A7030 |
Cpap full face mask |
205 |
189 |
$20K |
| A4604 |
Tubing with heating element |
470 |
436 |
$16K |
| E0570 |
Nebulizer with compression |
461 |
434 |
$14K |
| A7035 |
Pos airway press headgear |
429 |
400 |
$8K |
| K0001 |
Standard wheelchair |
620 |
569 |
$7K |
| A7038 |
Pos airway pressure filter |
1,444 |
1,344 |
$7K |
| E0562 |
Humidifier heated used w pap |
30 |
25 |
$5K |
| E0431 |
Portable gaseous 02 |
101 |
97 |
$1K |
| A7039 |
Filter, non disposable w pap |
99 |
86 |
$676.23 |
| K0195 |
Elevating whlchair leg rests |
39 |
37 |
$135.59 |
| A7003 |
Nebulizer administration set |
14 |
14 |
$42.26 |