| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,329 |
8,244 |
$518K |
| E0466 |
Home vent non-invasive inter |
1,164 |
1,155 |
$337K |
| K0001 |
Standard wheelchair |
3,353 |
3,314 |
$111K |
| K0738 |
Portable gas oxygen system |
3,046 |
3,032 |
$66K |
| E0143 |
Walker folding wheeled w/o s |
1,168 |
1,158 |
$56K |
| E0431 |
Portable gaseous 02 |
2,827 |
2,782 |
$41K |
| E0570 |
Nebulizer with compression |
1,013 |
1,012 |
$20K |
| E0601 |
Cont airway pressure device |
305 |
303 |
$12K |
| E1392 |
Portable oxygen concentrator |
561 |
556 |
$9K |
| A7038 |
Pos airway pressure filter |
965 |
961 |
$5K |
| E0260 |
Hosp bed semi-electr w/ matt |
178 |
173 |
$3K |
| A7035 |
Pos airway press headgear |
172 |
172 |
$2K |
| A7030 |
Cpap full face mask |
27 |
27 |
$1K |
| E0295 |
Hosp bed semi-elect w/o matt |
13 |
13 |
$1K |
| A7037 |
Pos airway pressure tubing |
67 |
67 |
$619.93 |
| A7034 |
Nasal application device |
13 |
13 |
$356.04 |
| A4604 |
Tubing with heating element |
12 |
12 |
$194.52 |
| A7046 |
Repl water chamber, pap dev |
24 |
24 |
$171.61 |
| A7039 |
Filter, non disposable w pap |
24 |
24 |
$126.02 |