| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,308 |
2,487 |
$144K |
| E0601 |
Cont airway pressure device |
1,573 |
1,130 |
$41K |
| E0431 |
Portable gaseous 02 |
2,237 |
1,724 |
$22K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,123 |
748 |
$20K |
| K0001 |
Standard wheelchair |
1,634 |
1,077 |
$18K |
| E0562 |
Humidifier heated used w pap |
694 |
446 |
$13K |
| E0570 |
Nebulizer with compression |
1,178 |
897 |
$9K |
| E0143 |
Walker folding wheeled w/o s |
539 |
373 |
$8K |
| K0003 |
Lightweight wheelchair |
287 |
187 |
$6K |
| E0630 |
Patient lift hydraulic |
319 |
184 |
$5K |
| A4604 |
Tubing with heating element |
215 |
156 |
$3K |
| K0195 |
Elevating whlchair leg rests |
745 |
505 |
$3K |
| A7035 |
Pos airway press headgear |
78 |
58 |
$1K |
| A7038 |
Pos airway pressure filter |
274 |
199 |
$845.02 |
| E0163 |
Commode chair with fixed arm |
14 |
12 |
$317.41 |