| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
12,427 |
9,710 |
$384K |
| E0601 |
Cont airway pressure device |
1,841 |
1,534 |
$47K |
| E0431 |
Portable gaseous 02 |
5,593 |
4,441 |
$29K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,190 |
791 |
$12K |
| E1392 |
Portable oxygen concentrator |
1,191 |
975 |
$6K |
| E0570 |
Nebulizer with compression |
2,149 |
1,811 |
$4K |
| K0001 |
Standard wheelchair |
668 |
497 |
$4K |
| E0562 |
Humidifier heated used w pap |
297 |
275 |
$1K |
| A7030 |
Cpap full face mask |
332 |
261 |
$715.34 |
| A4604 |
Tubing with heating element |
632 |
507 |
$562.58 |
| E0971 |
Wheelchair anti-tipping devi |
357 |
111 |
$291.17 |
| A7031 |
Replacement facemask interfa |
619 |
467 |
$192.93 |
| A7038 |
Pos airway pressure filter |
1,093 |
867 |
$79.23 |
| K0002 |
Stnd hemi (low seat) whlchr |
17 |
12 |
$55.69 |
| A7035 |
Pos airway press headgear |
117 |
96 |
$27.11 |
| E0961 |
Wheelchair brake extension |
216 |
86 |
$26.88 |
| K0738 |
Portable gas oxygen system |
468 |
405 |
$17.03 |
| A7033 |
Replacement nasal pillows |
31 |
24 |
$12.03 |
| A7046 |
Repl water chamber, pap dev |
51 |
41 |
$8.57 |
| A7034 |
Nasal application device |
31 |
24 |
$0.00 |