| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,458 |
4,263 |
$358K |
| E0431 |
Portable gaseous 02 |
3,769 |
3,624 |
$55K |
| E0601 |
Cont airway pressure device |
845 |
800 |
$30K |
| E0570 |
Nebulizer with compression |
103 |
97 |
$4K |
| A7038 |
Pos airway pressure filter |
733 |
672 |
$3K |
| A7035 |
Pos airway press headgear |
108 |
106 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
59 |
53 |
$763.31 |
| A7030 |
Cpap full face mask |
13 |
12 |
$676.47 |
| A7037 |
Pos airway pressure tubing |
55 |
52 |
$590.82 |
| A7046 |
Repl water chamber, pap dev |
56 |
52 |
$418.85 |
| K0001 |
Standard wheelchair |
13 |
13 |
$198.56 |
| A4450 |
Non-waterproof tape |
15 |
12 |
$159.69 |
| A7039 |
Filter, non disposable w pap |
12 |
12 |
$78.07 |
| A7003 |
Nebulizer administration set |
31 |
27 |
$54.55 |