| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,270 |
3,269 |
$155K |
| E0601 |
Cont airway pressure device |
1,339 |
1,338 |
$32K |
| E0431 |
Portable gaseous 02 |
2,567 |
2,566 |
$27K |
| E0260 |
Hosp bed semi-electr w/ matt |
854 |
854 |
$18K |
| E0570 |
Nebulizer with compression |
913 |
912 |
$10K |
| K0003 |
Lightweight wheelchair |
345 |
345 |
$6K |
| K0001 |
Standard wheelchair |
373 |
372 |
$3K |
| E0470 |
Rad w/o backup non-inv intfc |
41 |
41 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
45 |
45 |
$2K |
| A7038 |
Pos airway pressure filter |
257 |
257 |
$998.52 |
| A7035 |
Pos airway press headgear |
106 |
106 |
$779.33 |
| A4670 |
Automatic bp monitor, dial |
12 |
12 |
$635.46 |
| E0630 |
Patient lift hydraulic |
25 |
25 |
$583.33 |
| A7030 |
Cpap full face mask |
24 |
24 |
$437.54 |
| A7005 |
Nondisposable nebulizer set |
18 |
18 |
$286.54 |