| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,134 |
8,780 |
$345K |
| E0431 |
Portable gaseous 02 |
5,873 |
5,102 |
$194K |
| E0601 |
Cont airway pressure device |
2,441 |
2,197 |
$54K |
| A7030 |
Cpap full face mask |
803 |
677 |
$40K |
| A7031 |
Replacement facemask interfa |
1,212 |
928 |
$24K |
| E0570 |
Nebulizer with compression |
1,175 |
1,057 |
$13K |
| E0443 |
Portable 02 contents, gas |
278 |
221 |
$10K |
| A7038 |
Pos airway pressure filter |
1,990 |
1,533 |
$7K |
| A7035 |
Pos airway press headgear |
495 |
417 |
$6K |
| A4604 |
Tubing with heating element |
475 |
400 |
$5K |
| A7037 |
Pos airway pressure tubing |
185 |
173 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
82 |
75 |
$2K |
| A7046 |
Repl water chamber, pap dev |
277 |
232 |
$2K |
| A7039 |
Filter, non disposable w pap |
55 |
54 |
$280.16 |
| K0001 |
Standard wheelchair |
12 |
12 |
$221.86 |
| A7003 |
Nebulizer administration set |
12 |
12 |
$16.09 |