| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,086 |
2,570 |
$160K |
| E0601 |
Cont airway pressure device |
2,419 |
2,116 |
$87K |
| E0431 |
Portable gaseous 02 |
1,238 |
1,042 |
$10K |
| E0562 |
Humidifier heated used w pap |
1,271 |
1,174 |
$10K |
| K0001 |
Standard wheelchair |
436 |
366 |
$7K |
| E0260 |
Hosp bed semi-electr w/ matt |
288 |
216 |
$5K |
| E0570 |
Nebulizer with compression |
448 |
369 |
$4K |
| E1392 |
Portable oxygen concentrator |
449 |
410 |
$2K |
| E0470 |
Rad w/o backup non-inv intfc |
28 |
25 |
$2K |
| A7031 |
Replacement facemask interfa |
416 |
328 |
$709.34 |
| A7038 |
Pos airway pressure filter |
1,007 |
829 |
$644.27 |
| K0195 |
Elevating whlchair leg rests |
156 |
118 |
$433.22 |
| A7030 |
Cpap full face mask |
136 |
105 |
$192.60 |
| A4604 |
Tubing with heating element |
238 |
184 |
$105.96 |
| A7046 |
Repl water chamber, pap dev |
61 |
52 |
$47.01 |
| A7035 |
Pos airway press headgear |
113 |
82 |
$0.00 |
| A7034 |
Nasal application device |
28 |
26 |
$0.00 |
| A7032 |
Replacement nasal cushion |
15 |
12 |
$0.00 |