| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,746 |
2,546 |
$64K |
| E0431 |
Portable gaseous 02 |
2,387 |
2,195 |
$27K |
| E0260 |
Hosp bed semi-electr w/ matt |
449 |
442 |
$7K |
| E0601 |
Cont airway pressure device |
323 |
301 |
$5K |
| E0570 |
Nebulizer with compression |
523 |
516 |
$5K |
| K0001 |
Standard wheelchair |
500 |
477 |
$3K |
| A7038 |
Pos airway pressure filter |
441 |
407 |
$3K |
| A7035 |
Pos airway press headgear |
132 |
126 |
$2K |
| A7030 |
Cpap full face mask |
64 |
64 |
$2K |
| A4604 |
Tubing with heating element |
114 |
108 |
$741.39 |
| A7031 |
Replacement facemask interfa |
53 |
52 |
$635.17 |
| E0603 |
Electric breast pump |
31 |
13 |
$631.11 |
| E0443 |
Portable 02 contents, gas |
20 |
13 |
$501.07 |
| A7034 |
Nasal application device |
29 |
26 |
$477.09 |
| A7046 |
Repl water chamber, pap dev |
12 |
12 |
$82.68 |
| A7003 |
Nebulizer administration set |
30 |
30 |
$33.20 |