| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,463 |
1,991 |
$53K |
| E0431 |
Portable gaseous 02 |
1,790 |
1,431 |
$11K |
| E0601 |
Cont airway pressure device |
422 |
394 |
$8K |
| K0001 |
Standard wheelchair |
339 |
319 |
$7K |
| E0570 |
Nebulizer with compression |
206 |
200 |
$3K |
| A7030 |
Cpap full face mask |
114 |
103 |
$3K |
| E0260 |
Hosp bed semi-electr w/ matt |
69 |
66 |
$3K |
| A7031 |
Replacement facemask interfa |
87 |
82 |
$1K |
| E0973 |
W/ch access det adj armrest |
343 |
166 |
$1K |
| A7035 |
Pos airway press headgear |
175 |
158 |
$981.37 |
| E0971 |
Wheelchair anti-tipping devi |
390 |
189 |
$933.17 |
| A4604 |
Tubing with heating element |
107 |
94 |
$511.02 |
| A7034 |
Nasal application device |
28 |
26 |
$239.66 |
| A7038 |
Pos airway pressure filter |
398 |
354 |
$219.21 |
| E0951 |
Loop heel |
366 |
175 |
$215.81 |
| E0961 |
Wheelchair brake extension |
108 |
49 |
$175.74 |
| A7037 |
Pos airway pressure tubing |
16 |
16 |
$140.48 |
| A7005 |
Nondisposable nebulizer set |
12 |
12 |
$127.93 |
| A7046 |
Repl water chamber, pap dev |
46 |
44 |
$81.07 |
| E0978 |
W/c acc,saf belt pelv strap |
57 |
52 |
$61.35 |
| A7039 |
Filter, non disposable w pap |
16 |
13 |
$55.35 |
| A7003 |
Nebulizer administration set |
12 |
12 |
$0.51 |