| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,263 |
3,582 |
$171K |
| E0601 |
Cont airway pressure device |
4,879 |
3,188 |
$139K |
| E0431 |
Portable gaseous 02 |
2,717 |
1,909 |
$17K |
| E0430 |
Oxygen system gas portable |
173 |
99 |
$5K |
| E0562 |
Humidifier heated used w pap |
362 |
200 |
$3K |
| A7030 |
Cpap full face mask |
110 |
98 |
$2K |
| K0003 |
Lightweight wheelchair |
335 |
254 |
$2K |
| E0570 |
Nebulizer with compression |
543 |
378 |
$1K |
| A7037 |
Pos airway pressure tubing |
811 |
689 |
$634.86 |
| A7034 |
Nasal application device |
168 |
149 |
$509.06 |
| A7035 |
Pos airway press headgear |
181 |
144 |
$484.01 |
| A7038 |
Pos airway pressure filter |
1,381 |
1,165 |
$329.34 |
| A7046 |
Repl water chamber, pap dev |
90 |
75 |
$270.25 |
| A7031 |
Replacement facemask interfa |
127 |
104 |
$266.94 |
| K0195 |
Elevating whlchair leg rests |
153 |
101 |
$221.88 |
| A7032 |
Replacement nasal cushion |
14 |
13 |
$65.86 |
| K0001 |
Standard wheelchair |
20 |
12 |
$34.54 |
| A7039 |
Filter, non disposable w pap |
72 |
52 |
$2.34 |