| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,757 |
3,757 |
$206K |
| E0601 |
Cont airway pressure device |
1,818 |
1,814 |
$63K |
| E0570 |
Nebulizer with compression |
946 |
946 |
$26K |
| E0562 |
Humidifier heated used w pap |
1,548 |
1,545 |
$24K |
| E0260 |
Hosp bed semi-electr w/ matt |
776 |
775 |
$23K |
| E0431 |
Portable gaseous 02 |
1,853 |
1,853 |
$20K |
| K0001 |
Standard wheelchair |
744 |
744 |
$18K |
| A7030 |
Cpap full face mask |
217 |
217 |
$15K |
| E0470 |
Rad w/o backup non-inv intfc |
89 |
89 |
$11K |
| E0471 |
Rad w/backup non inv intrfc |
42 |
42 |
$10K |
| A7035 |
Pos airway press headgear |
489 |
489 |
$8K |
| A7034 |
Nasal application device |
86 |
86 |
$4K |
| K0738 |
Portable gas oxygen system |
295 |
295 |
$3K |
| A4604 |
Tubing with heating element |
228 |
228 |
$2K |
| A7038 |
Pos airway pressure filter |
652 |
651 |
$2K |
| A7037 |
Pos airway pressure tubing |
81 |
81 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
14 |
14 |
$697.41 |
| A7003 |
Nebulizer administration set |
136 |
134 |
$313.04 |
| A7015 |
Aerosol mask used w nebulize |
12 |
12 |
$14.22 |