| Code | Description | Claims | Beneficiaries | Total Paid |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,041 |
933 |
$9K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
73 |
73 |
$3K |
| A4554 |
Disposable underpads, all sizes |
58 |
58 |
$3K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
52 |
52 |
$1K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
12 |
12 |
$211.74 |
| A4335 |
Incontinence supply; miscellaneous |
50 |
50 |
$179.50 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
157 |
135 |
$137.07 |
| A7037 |
Tubing used with positive airway pressure device |
37 |
37 |
$126.94 |
| A7035 |
Headgear used with positive airway pressure device |
25 |
25 |
$94.44 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
14 |
14 |
$61.04 |