| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,796 |
6,078 |
$251K |
| K0108 |
W/c component-accessory nos |
58 |
39 |
$58K |
| E0601 |
Cont airway pressure device |
1,682 |
1,510 |
$49K |
| E0431 |
Portable gaseous 02 |
4,089 |
3,639 |
$39K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,437 |
1,321 |
$37K |
| E0570 |
Nebulizer with compression |
2,338 |
2,111 |
$37K |
| K0001 |
Standard wheelchair |
1,354 |
1,241 |
$14K |
| E0971 |
Wheelchair anti-tipping devi |
2,647 |
1,281 |
$12K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
328 |
309 |
$8K |
| E0260 |
Hosp bed semi-electr w/ matt |
209 |
197 |
$7K |
| E2620 |
Wc planar back cush wd <22in |
14 |
12 |
$5K |
| E1028 |
W/c manual swingaway |
75 |
43 |
$4K |
| A7037 |
Pos airway pressure tubing |
160 |
153 |
$2K |
| E0955 |
Cushioned headrest |
18 |
12 |
$2K |
| A7003 |
Nebulizer administration set |
289 |
259 |
$832.44 |
| E1392 |
Portable oxygen concentrator |
87 |
75 |
$789.18 |
| A7035 |
Pos airway press headgear |
68 |
65 |
$669.27 |
| A7038 |
Pos airway pressure filter |
109 |
93 |
$458.33 |
| A7030 |
Cpap full face mask |
13 |
13 |
$384.05 |
| A7015 |
Aerosol mask used w nebulize |
199 |
169 |
$198.41 |