| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
2,568 |
2,112 |
$60K |
| E1390 |
Oxygen concentrator |
1,002 |
806 |
$25K |
| A7030 |
Cpap full face mask |
594 |
433 |
$21K |
| A7031 |
Replacement facemask interfa |
1,071 |
751 |
$17K |
| E0562 |
Humidifier heated used w pap |
2,357 |
1,973 |
$16K |
| K0001 |
Standard wheelchair |
1,082 |
812 |
$10K |
| A7035 |
Pos airway press headgear |
934 |
684 |
$7K |
| A7037 |
Pos airway pressure tubing |
1,203 |
881 |
$7K |
| A7038 |
Pos airway pressure filter |
2,023 |
1,427 |
$4K |
| E0431 |
Portable gaseous 02 |
706 |
549 |
$4K |
| A7034 |
Nasal application device |
114 |
90 |
$3K |
| E0570 |
Nebulizer with compression |
48 |
40 |
$2K |
| L4387 |
Non-pneum walk boot pre ots |
16 |
13 |
$1K |
| A7033 |
Replacement nasal pillows |
15 |
12 |
$461.61 |
| A7039 |
Filter, non disposable w pap |
182 |
125 |
$410.25 |
| E0250 |
Hosp bed fixed ht w/ mattres |
15 |
12 |
$128.22 |
| A7046 |
Repl water chamber, pap dev |
14 |
13 |
$43.85 |