| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,903 |
4,441 |
$334K |
| B4035 |
Enteral feed supp pump per d |
681 |
409 |
$89K |
| E0601 |
Cont airway pressure device |
1,505 |
1,184 |
$50K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,646 |
1,189 |
$42K |
| K0738 |
Portable gas oxygen system |
2,242 |
1,666 |
$35K |
| E0431 |
Portable gaseous 02 |
2,422 |
1,869 |
$26K |
| A7030 |
Cpap full face mask |
474 |
382 |
$25K |
| K0001 |
Standard wheelchair |
2,438 |
1,815 |
$18K |
| A7031 |
Replacement facemask interfa |
806 |
592 |
$17K |
| A4554 |
Disposable underpads |
228 |
166 |
$9K |
| A7038 |
Pos airway pressure filter |
1,786 |
1,344 |
$5K |
| E0570 |
Nebulizer with compression |
654 |
460 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
100 |
79 |
$3K |
| A4604 |
Tubing with heating element |
235 |
202 |
$3K |
| A7035 |
Pos airway press headgear |
193 |
154 |
$2K |
| A7037 |
Pos airway pressure tubing |
75 |
53 |
$1K |
| A7046 |
Repl water chamber, pap dev |
88 |
74 |
$351.79 |