| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,771 |
3,555 |
$170K |
| A7030 |
Cpap full face mask |
1,537 |
1,479 |
$87K |
| E0601 |
Cont airway pressure device |
1,722 |
1,667 |
$51K |
| A7031 |
Replacement facemask interfa |
1,681 |
1,608 |
$51K |
| A4604 |
Tubing with heating element |
2,148 |
2,066 |
$49K |
| A7034 |
Nasal application device |
868 |
834 |
$32K |
| E0431 |
Portable gaseous 02 |
2,360 |
2,240 |
$26K |
| E0260 |
Hosp bed semi-electr w/ matt |
488 |
464 |
$25K |
| E0562 |
Humidifier heated used w pap |
1,663 |
1,598 |
$24K |
| A7032 |
Replacement nasal cushion |
601 |
560 |
$19K |
| A7035 |
Pos airway press headgear |
1,426 |
1,384 |
$17K |
| E0470 |
Rad w/o backup non-inv intfc |
298 |
289 |
$13K |
| K0001 |
Standard wheelchair |
442 |
426 |
$12K |
| A7038 |
Pos airway pressure filter |
2,696 |
2,595 |
$11K |
| E1392 |
Portable oxygen concentrator |
884 |
857 |
$9K |
| A7046 |
Repl water chamber, pap dev |
1,091 |
1,050 |
$8K |
| K0003 |
Lightweight wheelchair |
42 |
36 |
$2K |
| A7039 |
Filter, non disposable w pap |
266 |
254 |
$1K |
| E0570 |
Nebulizer with compression |
107 |
107 |
$1K |
| A7037 |
Pos airway pressure tubing |
95 |
92 |
$991.25 |
| E0971 |
Wheelchair anti-tipping devi |
70 |
63 |
$287.98 |