| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,774 |
4,345 |
$229K |
| E0570 |
Nebulizer with compression |
3,275 |
2,977 |
$98K |
| A7030 |
Cpap full face mask |
1,241 |
1,111 |
$71K |
| E0601 |
Cont airway pressure device |
1,349 |
1,287 |
$57K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,356 |
1,273 |
$46K |
| A7031 |
Replacement facemask interfa |
1,145 |
1,024 |
$36K |
| E0431 |
Portable gaseous 02 |
2,594 |
2,390 |
$33K |
| A7037 |
Pos airway pressure tubing |
2,128 |
1,932 |
$32K |
| A7035 |
Pos airway press headgear |
1,074 |
963 |
$22K |
| E1392 |
Portable oxygen concentrator |
987 |
902 |
$12K |
| A7005 |
Nondisposable nebulizer set |
947 |
834 |
$12K |
| K0001 |
Standard wheelchair |
850 |
826 |
$12K |
| A7034 |
Nasal application device |
440 |
416 |
$11K |
| K0003 |
Lightweight wheelchair |
341 |
329 |
$8K |
| A7038 |
Pos airway pressure filter |
2,224 |
1,960 |
$7K |
| A7046 |
Repl water chamber, pap dev |
494 |
459 |
$3K |
| A7039 |
Filter, non disposable w pap |
727 |
662 |
$3K |
| A7032 |
Replacement nasal cushion |
98 |
93 |
$2K |
| E0562 |
Humidifier heated used w pap |
26 |
26 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
945 |
833 |
$1K |
| A7013 |
Disposable compressor filter |
967 |
834 |
$424.13 |