| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,929 |
3,464 |
$251K |
| E0601 |
Cont airway pressure device |
3,967 |
2,873 |
$165K |
| E0562 |
Humidifier heated used w pap |
2,514 |
1,602 |
$56K |
| A7030 |
Cpap full face mask |
654 |
480 |
$52K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,833 |
1,175 |
$34K |
| E0570 |
Nebulizer with compression |
1,465 |
975 |
$28K |
| E1392 |
Portable oxygen concentrator |
2,010 |
1,349 |
$27K |
| A4554 |
Disposable underpads |
603 |
495 |
$26K |
| T4526 |
Adult size pull-on med |
258 |
211 |
$24K |
| A7035 |
Pos airway press headgear |
1,242 |
882 |
$18K |
| K0001 |
Standard wheelchair |
2,475 |
1,521 |
$17K |
| T4527 |
Adult size pull-on lg |
171 |
113 |
$14K |
| A7031 |
Replacement facemask interfa |
517 |
361 |
$13K |
| K0738 |
Portable gas oxygen system |
1,139 |
770 |
$11K |
| A7034 |
Nasal application device |
267 |
191 |
$9K |
| A4604 |
Tubing with heating element |
629 |
459 |
$8K |
| A7037 |
Pos airway pressure tubing |
284 |
207 |
$7K |
| A7038 |
Pos airway pressure filter |
2,177 |
1,545 |
$6K |
| A4627 |
Spacer bag/reservoir |
14 |
12 |
$416.12 |
| A7046 |
Repl water chamber, pap dev |
71 |
52 |
$245.59 |
| E0431 |
Portable gaseous 02 |
14 |
13 |
$209.20 |