| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,300 |
3,023 |
$122K |
| E0601 |
Cont airway pressure device |
805 |
626 |
$37K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,391 |
942 |
$26K |
| K0001 |
Standard wheelchair |
2,226 |
1,648 |
$25K |
| E0431 |
Portable gaseous 02 |
2,845 |
2,185 |
$19K |
| A4604 |
Tubing with heating element |
803 |
650 |
$15K |
| E0570 |
Nebulizer with compression |
1,063 |
780 |
$13K |
| A7034 |
Nasal application device |
154 |
118 |
$3K |
| A7035 |
Pos airway press headgear |
308 |
250 |
$3K |
| E0562 |
Humidifier heated used w pap |
242 |
189 |
$2K |
| A7038 |
Pos airway pressure filter |
1,282 |
990 |
$1K |
| A7046 |
Repl water chamber, pap dev |
192 |
154 |
$1K |
| E0181 |
Press pad alternating w/ pum |
150 |
93 |
$346.81 |
| B4034 |
Enter feed supkit syr by day |
18 |
12 |
$273.78 |