| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
11,983 |
7,420 |
$556K |
| E0601 |
Cont airway pressure device |
4,523 |
2,797 |
$124K |
| A7030 |
Cpap full face mask |
1,818 |
1,208 |
$94K |
| A7031 |
Replacement facemask interfa |
2,125 |
1,423 |
$57K |
| E0431 |
Portable gaseous 02 |
7,792 |
4,736 |
$57K |
| E0562 |
Humidifier heated used w pap |
4,774 |
2,902 |
$40K |
| A7037 |
Pos airway pressure tubing |
2,387 |
1,605 |
$27K |
| A7035 |
Pos airway press headgear |
1,681 |
1,150 |
$20K |
| A7038 |
Pos airway pressure filter |
4,114 |
2,848 |
$15K |
| K0001 |
Standard wheelchair |
735 |
453 |
$8K |
| E0260 |
Hosp bed semi-electr w/ matt |
499 |
289 |
$8K |
| E0570 |
Nebulizer with compression |
1,825 |
1,193 |
$8K |
| A7034 |
Nasal application device |
99 |
63 |
$4K |
| A7032 |
Replacement nasal cushion |
118 |
52 |
$3K |
| A7046 |
Repl water chamber, pap dev |
443 |
316 |
$2K |
| A7039 |
Filter, non disposable w pap |
260 |
180 |
$1K |
| A4604 |
Tubing with heating element |
22 |
12 |
$173.83 |