| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,943 |
3,495 |
$173K |
| E0570 |
Nebulizer with compression |
3,493 |
3,129 |
$103K |
| E0601 |
Cont airway pressure device |
2,934 |
2,608 |
$75K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,900 |
1,751 |
$62K |
| A7030 |
Cpap full face mask |
1,250 |
1,080 |
$59K |
| E0431 |
Portable gaseous 02 |
2,627 |
2,377 |
$31K |
| A7038 |
Pos airway pressure filter |
3,319 |
2,862 |
$22K |
| K0001 |
Standard wheelchair |
1,906 |
1,753 |
$18K |
| A7031 |
Replacement facemask interfa |
864 |
764 |
$17K |
| A4554 |
Disposable underpads |
632 |
555 |
$15K |
| T4527 |
Adult size pull-on lg |
88 |
79 |
$10K |
| A4604 |
Tubing with heating element |
722 |
638 |
$7K |
| A7035 |
Pos airway press headgear |
670 |
582 |
$7K |
| A7037 |
Pos airway pressure tubing |
314 |
250 |
$5K |
| L0650 |
Lso sc r ant/pos pnl pre ots |
15 |
15 |
$4K |
| A7034 |
Nasal application device |
30 |
28 |
$897.59 |
| E0143 |
Walker folding wheeled w/o s |
54 |
51 |
$825.16 |
| A7003 |
Nebulizer administration set |
76 |
67 |
$124.37 |