| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,551 |
5,388 |
$385K |
| A7030 |
Cpap full face mask |
1,260 |
1,241 |
$112K |
| E0601 |
Cont airway pressure device |
1,713 |
1,690 |
$87K |
| E0431 |
Portable gaseous 02 |
4,251 |
4,172 |
$54K |
| A4604 |
Tubing with heating element |
946 |
926 |
$39K |
| E0562 |
Humidifier heated used w pap |
1,804 |
1,773 |
$32K |
| K0001 |
Standard wheelchair |
1,641 |
1,612 |
$24K |
| A7031 |
Replacement facemask interfa |
549 |
543 |
$19K |
| A7038 |
Pos airway pressure filter |
2,714 |
2,663 |
$13K |
| A7035 |
Pos airway press headgear |
509 |
492 |
$10K |
| T4523 |
Adult size brief/diaper lg |
24 |
24 |
$3K |
| E0570 |
Nebulizer with compression |
95 |
92 |
$3K |
| A4927 |
Non-sterile gloves |
115 |
112 |
$2K |
| A7046 |
Repl water chamber, pap dev |
172 |
168 |
$2K |
| E0424 |
Stationary compressed gas 02 |
20 |
18 |
$1K |
| A4351 |
Straight tip urine catheter |
17 |
12 |
$1K |
| A7037 |
Pos airway pressure tubing |
12 |
12 |
$163.08 |
| E0443 |
Portable 02 contents, gas |
12 |
12 |
$24.68 |