| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
763 |
536 |
$15K |
| E0260 |
Hosp bed semi-electr w/ matt |
544 |
397 |
$7K |
| E0601 |
Cont airway pressure device |
454 |
358 |
$5K |
| K0001 |
Standard wheelchair |
661 |
498 |
$3K |
| E0570 |
Nebulizer with compression |
251 |
171 |
$1K |
| A7030 |
Cpap full face mask |
12 |
12 |
$1K |
| K0738 |
Portable gas oxygen system |
192 |
145 |
$1K |
| E1392 |
Portable oxygen concentrator |
108 |
81 |
$1K |
| A4604 |
Tubing with heating element |
66 |
64 |
$930.09 |
| A7038 |
Pos airway pressure filter |
325 |
262 |
$814.15 |
| A7031 |
Replacement facemask interfa |
39 |
37 |
$752.51 |
| E0143 |
Walker folding wheeled w/o s |
44 |
31 |
$609.01 |
| K0195 |
Elevating whlchair leg rests |
33 |
24 |
$159.48 |
| K0003 |
Lightweight wheelchair |
16 |
12 |
$123.66 |