| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,092 |
5,667 |
$354K |
| E0601 |
Cont airway pressure device |
692 |
647 |
$22K |
| E0431 |
Portable gaseous 02 |
1,914 |
1,750 |
$21K |
| K0001 |
Standard wheelchair |
799 |
737 |
$19K |
| K0738 |
Portable gas oxygen system |
1,088 |
1,030 |
$15K |
| A7030 |
Cpap full face mask |
239 |
220 |
$13K |
| E0603 |
Electric breast pump |
64 |
61 |
$12K |
| E0570 |
Nebulizer with compression |
775 |
707 |
$8K |
| A4604 |
Tubing with heating element |
397 |
370 |
$8K |
| E1392 |
Portable oxygen concentrator |
1,011 |
955 |
$8K |
| E0445 |
Oximeter non-invasive |
492 |
475 |
$8K |
| A7035 |
Pos airway press headgear |
576 |
549 |
$8K |
| A7031 |
Replacement facemask interfa |
263 |
247 |
$6K |
| E0260 |
Hosp bed semi-electr w/ matt |
119 |
119 |
$4K |
| A7038 |
Pos airway pressure filter |
1,023 |
954 |
$3K |
| A7034 |
Nasal application device |
30 |
26 |
$1K |
| E0114 |
Crutch underarm pair no wood |
28 |
28 |
$625.89 |
| A7046 |
Repl water chamber, pap dev |
90 |
82 |
$536.77 |
| A7039 |
Filter, non disposable w pap |
12 |
12 |
$60.97 |