| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,956 |
2,392 |
$76K |
| E0601 |
Cont airway pressure device |
1,428 |
1,036 |
$23K |
| E0431 |
Portable gaseous 02 |
1,792 |
1,427 |
$12K |
| A7030 |
Cpap full face mask |
357 |
245 |
$9K |
| A7031 |
Replacement facemask interfa |
497 |
374 |
$8K |
| A4604 |
Tubing with heating element |
725 |
499 |
$7K |
| E1392 |
Portable oxygen concentrator |
717 |
622 |
$6K |
| A7038 |
Pos airway pressure filter |
994 |
730 |
$2K |
| E0570 |
Nebulizer with compression |
893 |
693 |
$2K |
| K0001 |
Standard wheelchair |
369 |
258 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
131 |
96 |
$2K |
| A7035 |
Pos airway press headgear |
255 |
175 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
17 |
12 |
$237.97 |
| A7046 |
Repl water chamber, pap dev |
21 |
12 |
$28.27 |