| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,669 |
10,646 |
$522K |
| A7030 |
Cpap full face mask |
3,008 |
2,993 |
$145K |
| E0601 |
Cont airway pressure device |
3,689 |
3,686 |
$119K |
| A7031 |
Replacement facemask interfa |
4,397 |
4,355 |
$117K |
| E0431 |
Portable gaseous 02 |
5,682 |
5,671 |
$59K |
| E1392 |
Portable oxygen concentrator |
1,960 |
1,958 |
$47K |
| E0562 |
Humidifier heated used w pap |
3,909 |
3,904 |
$37K |
| A7035 |
Pos airway press headgear |
2,841 |
2,827 |
$32K |
| A7037 |
Pos airway pressure tubing |
3,242 |
3,230 |
$23K |
| A7038 |
Pos airway pressure filter |
7,071 |
7,020 |
$19K |
| E0570 |
Nebulizer with compression |
2,269 |
2,266 |
$14K |
| A7034 |
Nasal application device |
285 |
284 |
$8K |
| A7032 |
Replacement nasal cushion |
203 |
201 |
$5K |
| A7046 |
Repl water chamber, pap dev |
1,237 |
1,233 |
$4K |
| A4604 |
Tubing with heating element |
391 |
391 |
$4K |
| K0001 |
Standard wheelchair |
174 |
174 |
$2K |
| K0195 |
Elevating whlchair leg rests |
133 |
132 |
$652.84 |
| A7003 |
Nebulizer administration set |
219 |
207 |
$269.34 |
| E0260 |
Hosp bed semi-electr w/ matt |
12 |
12 |
$10.46 |