| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,034 |
1,032 |
$71K |
| E0601 |
Cont airway pressure device |
1,636 |
1,597 |
$57K |
| E0603 |
Electric breast pump |
318 |
318 |
$38K |
| E0445 |
Oximeter non-invasive |
67 |
67 |
$13K |
| E0431 |
Portable gaseous 02 |
676 |
668 |
$11K |
| K0003 |
Lightweight wheelchair |
215 |
215 |
$9K |
| A4927 |
Non-sterile gloves |
227 |
214 |
$8K |
| A7030 |
Cpap full face mask |
113 |
109 |
$5K |
| K0001 |
Standard wheelchair |
190 |
188 |
$3K |
| E0600 |
Suction pump portab hom modl |
53 |
53 |
$3K |
| A7035 |
Pos airway press headgear |
218 |
214 |
$3K |
| A7520 |
Trach/laryn tube non-cuffed |
29 |
28 |
$2K |
| A7038 |
Pos airway pressure filter |
362 |
358 |
$2K |
| K0195 |
Elevating whlchair leg rests |
168 |
168 |
$1K |
| A7037 |
Pos airway pressure tubing |
102 |
100 |
$1K |
| A7034 |
Nasal application device |
43 |
43 |
$830.90 |
| E0562 |
Humidifier heated used w pap |
13 |
13 |
$716.68 |
| E0971 |
Wheelchair anti-tipping devi |
14 |
12 |
$714.96 |
| A7031 |
Replacement facemask interfa |
39 |
37 |
$690.63 |
| A7000 |
Disposable canister for pump |
86 |
81 |
$410.03 |
| A4604 |
Tubing with heating element |
12 |
12 |
$68.13 |
| A7046 |
Repl water chamber, pap dev |
12 |
12 |
$57.74 |