| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,401 |
4,028 |
$251K |
| E0601 |
Cont airway pressure device |
2,343 |
1,682 |
$62K |
| E0431 |
Portable gaseous 02 |
3,883 |
2,992 |
$40K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,218 |
809 |
$29K |
| E0570 |
Nebulizer with compression |
2,907 |
2,155 |
$24K |
| K0001 |
Standard wheelchair |
1,854 |
1,295 |
$19K |
| E0562 |
Humidifier heated used w pap |
1,060 |
709 |
$16K |
| A4604 |
Tubing with heating element |
1,029 |
761 |
$14K |
| A7030 |
Cpap full face mask |
246 |
183 |
$11K |
| A7038 |
Pos airway pressure filter |
1,164 |
892 |
$4K |
| A7031 |
Replacement facemask interfa |
90 |
64 |
$3K |
| A7035 |
Pos airway press headgear |
292 |
219 |
$3K |
| K0003 |
Lightweight wheelchair |
87 |
67 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
76 |
63 |
$2K |
| K0738 |
Portable gas oxygen system |
26 |
24 |
$636.41 |
| K0195 |
Elevating whlchair leg rests |
159 |
98 |
$447.87 |
| A7046 |
Repl water chamber, pap dev |
79 |
59 |
$319.70 |