| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,808 |
4,082 |
$162K |
| E0601 |
Cont airway pressure device |
2,767 |
2,024 |
$70K |
| E0570 |
Nebulizer with compression |
3,406 |
2,368 |
$43K |
| E0562 |
Humidifier heated used w pap |
1,816 |
1,478 |
$21K |
| K0738 |
Portable gas oxygen system |
2,367 |
1,665 |
$17K |
| A7030 |
Cpap full face mask |
214 |
159 |
$11K |
| A7035 |
Pos airway press headgear |
770 |
545 |
$8K |
| A7038 |
Pos airway pressure filter |
1,971 |
1,424 |
$6K |
| E0260 |
Hosp bed semi-electr w/ matt |
292 |
195 |
$5K |
| A4604 |
Tubing with heating element |
167 |
132 |
$4K |
| A7031 |
Replacement facemask interfa |
143 |
102 |
$3K |
| A7037 |
Pos airway pressure tubing |
268 |
167 |
$1K |
| A7034 |
Nasal application device |
36 |
24 |
$1K |
| A7046 |
Repl water chamber, pap dev |
119 |
96 |
$568.09 |
| E1140 |
Wheelchair standard detach a |
24 |
24 |
$524.06 |
| A7039 |
Filter, non disposable w pap |
147 |
98 |
$418.42 |