| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,830 |
3,744 |
$221K |
| E0601 |
Cont airway pressure device |
618 |
600 |
$40K |
| E0570 |
Nebulizer with compression |
819 |
812 |
$28K |
| E0431 |
Portable gaseous 02 |
2,046 |
2,032 |
$26K |
| E0562 |
Humidifier heated used w pap |
875 |
858 |
$15K |
| E1161 |
Manual adult wc w tiltinspac |
419 |
419 |
$14K |
| A7030 |
Cpap full face mask |
212 |
211 |
$13K |
| E0955 |
Cushioned headrest |
388 |
386 |
$4K |
| A7035 |
Pos airway press headgear |
216 |
215 |
$2K |
| E1028 |
W/c manual swingaway |
481 |
410 |
$2K |
| E0470 |
Rad w/o backup non-inv intfc |
12 |
12 |
$2K |
| A7038 |
Pos airway pressure filter |
605 |
603 |
$1K |
| A7037 |
Pos airway pressure tubing |
116 |
116 |
$1K |
| A7031 |
Replacement facemask interfa |
12 |
12 |
$485.86 |
| K0739 |
Repair/svc dme non-oxygen eq |
12 |
12 |
$86.65 |