| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E2402 |
Neg press wound therapy pump |
1,240 |
740 |
$297K |
| E1390 |
Oxygen concentrator |
15,720 |
13,596 |
$287K |
| E0431 |
Portable gaseous 02 |
6,011 |
4,947 |
$31K |
| E1392 |
Portable oxygen concentrator |
4,300 |
3,737 |
$27K |
| E0601 |
Cont airway pressure device |
1,602 |
1,403 |
$22K |
| A6550 |
Neg pres wound ther drsg set |
299 |
145 |
$17K |
| A7034 |
Nasal application device |
462 |
338 |
$9K |
| E0260 |
Hosp bed semi-electr w/ matt |
948 |
689 |
$8K |
| A4604 |
Tubing with heating element |
607 |
451 |
$8K |
| K0001 |
Standard wheelchair |
1,363 |
1,153 |
$8K |
| A7035 |
Pos airway press headgear |
966 |
705 |
$6K |
| A7038 |
Pos airway pressure filter |
2,531 |
1,815 |
$5K |
| E0570 |
Nebulizer with compression |
608 |
507 |
$4K |
| A7000 |
Disposable canister for pump |
249 |
118 |
$3K |
| K0738 |
Portable gas oxygen system |
311 |
252 |
$3K |
| A7030 |
Cpap full face mask |
109 |
81 |
$3K |
| A7031 |
Replacement facemask interfa |
195 |
134 |
$3K |
| A7046 |
Repl water chamber, pap dev |
317 |
234 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
48 |
41 |
$866.72 |
| A7037 |
Pos airway pressure tubing |
69 |
50 |
$381.82 |
| A7033 |
Replacement nasal pillows |
30 |
24 |
$308.52 |
| E0562 |
Humidifier heated used w pap |
13 |
12 |
$257.40 |