| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,868 |
5,158 |
$191K |
| E0601 |
Cont airway pressure device |
2,195 |
1,932 |
$48K |
| E0431 |
Portable gaseous 02 |
1,250 |
1,090 |
$26K |
| K0738 |
Portable gas oxygen system |
897 |
787 |
$20K |
| A7030 |
Cpap full face mask |
200 |
167 |
$11K |
| A7031 |
Replacement facemask interfa |
528 |
417 |
$10K |
| A4604 |
Tubing with heating element |
776 |
676 |
$10K |
| K0001 |
Standard wheelchair |
756 |
616 |
$7K |
| A7038 |
Pos airway pressure filter |
1,491 |
1,163 |
$5K |
| A7034 |
Nasal application device |
163 |
141 |
$3K |
| A7035 |
Pos airway press headgear |
269 |
236 |
$3K |
| E0260 |
Hosp bed semi-electr w/ matt |
101 |
87 |
$2K |
| E0562 |
Humidifier heated used w pap |
113 |
94 |
$2K |
| A7046 |
Repl water chamber, pap dev |
213 |
185 |
$1K |
| A7032 |
Replacement nasal cushion |
132 |
85 |
$1K |
| A7037 |
Pos airway pressure tubing |
16 |
13 |
$287.26 |
| E0570 |
Nebulizer with compression |
53 |
51 |
$67.63 |