| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
7,869 |
7,696 |
$339K |
| E0431 |
Portable gaseous 02 |
4,108 |
4,029 |
$38K |
| E0570 |
Nebulizer with compression |
758 |
748 |
$3K |
| A7038 |
Pos airway pressure filter |
481 |
464 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
50 |
50 |
$918.01 |
| A7031 |
Replacement facemask interfa |
25 |
24 |
$867.45 |
| E0601 |
Cont airway pressure device |
55 |
51 |
$789.88 |
| A7003 |
Nebulizer administration set |
798 |
757 |
$691.74 |
| E0562 |
Humidifier heated used w pap |
57 |
56 |
$501.87 |
| E1392 |
Portable oxygen concentrator |
117 |
115 |
$296.40 |
| A7037 |
Pos airway pressure tubing |
12 |
12 |
$167.51 |
| K0001 |
Standard wheelchair |
12 |
12 |
$74.42 |