| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,755 |
5,568 |
$130K |
| E0431 |
Portable gaseous 02 |
4,459 |
3,694 |
$19K |
| K0003 |
Lightweight wheelchair |
1,650 |
1,270 |
$12K |
| E0261 |
Hosp bed semi-electr w/o mat |
947 |
729 |
$10K |
| E0601 |
Cont airway pressure device |
486 |
375 |
$8K |
| K0195 |
Elevating whlchair leg rests |
2,469 |
1,907 |
$5K |
| K0001 |
Standard wheelchair |
815 |
655 |
$4K |
| E2402 |
Neg press wound therapy pump |
36 |
27 |
$4K |
| E0570 |
Nebulizer with compression |
1,920 |
1,471 |
$3K |
| A7037 |
Pos airway pressure tubing |
312 |
277 |
$2K |
| A7038 |
Pos airway pressure filter |
733 |
602 |
$1K |
| E0562 |
Humidifier heated used w pap |
343 |
276 |
$1K |
| A7034 |
Nasal application device |
48 |
38 |
$1K |
| E1392 |
Portable oxygen concentrator |
85 |
62 |
$410.18 |
| A7032 |
Replacement nasal cushion |
16 |
14 |
$340.38 |
| A7035 |
Pos airway press headgear |
30 |
26 |
$199.41 |
| A7046 |
Repl water chamber, pap dev |
41 |
38 |
$194.10 |