| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,754 |
4,976 |
$156K |
| A7030 |
Cpap full face mask |
1,381 |
1,184 |
$62K |
| A7031 |
Replacement facemask interfa |
3,180 |
2,659 |
$59K |
| E0601 |
Cont airway pressure device |
2,339 |
2,011 |
$51K |
| E0562 |
Humidifier heated used w pap |
2,408 |
2,053 |
$18K |
| E0431 |
Portable gaseous 02 |
2,968 |
2,560 |
$17K |
| A7035 |
Pos airway press headgear |
1,162 |
982 |
$11K |
| E1392 |
Portable oxygen concentrator |
1,128 |
948 |
$11K |
| A7032 |
Replacement nasal cushion |
434 |
373 |
$10K |
| A4604 |
Tubing with heating element |
533 |
420 |
$10K |
| A7038 |
Pos airway pressure filter |
3,903 |
3,244 |
$10K |
| A7037 |
Pos airway pressure tubing |
1,160 |
1,009 |
$8K |
| A7034 |
Nasal application device |
247 |
203 |
$7K |
| K0003 |
Lightweight wheelchair |
612 |
523 |
$7K |
| E0570 |
Nebulizer with compression |
1,228 |
1,127 |
$4K |
| A7033 |
Replacement nasal pillows |
245 |
210 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
373 |
293 |
$3K |
| K0001 |
Standard wheelchair |
542 |
432 |
$3K |
| E0261 |
Hosp bed semi-electr w/o mat |
235 |
221 |
$2K |
| A7046 |
Repl water chamber, pap dev |
391 |
325 |
$2K |
| E0443 |
Portable 02 contents, gas |
221 |
190 |
$2K |
| A7039 |
Filter, non disposable w pap |
603 |
510 |
$2K |
| E0973 |
W/ch access det adj armrest |
267 |
100 |
$370.84 |
| E0971 |
Wheelchair anti-tipping devi |
483 |
205 |
$201.36 |
| E0951 |
Loop heel |
172 |
81 |
$56.77 |