| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,972 |
2,928 |
$132K |
| E0601 |
Cont airway pressure device |
604 |
591 |
$25K |
| E0431 |
Portable gaseous 02 |
1,800 |
1,767 |
$18K |
| E0562 |
Humidifier heated used w pap |
147 |
146 |
$3K |
| A7031 |
Replacement facemask interfa |
134 |
122 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
140 |
140 |
$2K |
| A7030 |
Cpap full face mask |
57 |
53 |
$2K |
| A7038 |
Pos airway pressure filter |
551 |
509 |
$2K |
| E0570 |
Nebulizer with compression |
829 |
818 |
$887.65 |
| E1392 |
Portable oxygen concentrator |
508 |
504 |
$846.16 |
| E0443 |
Portable 02 contents, gas |
24 |
24 |
$817.52 |
| A7035 |
Pos airway press headgear |
51 |
50 |
$392.56 |
| A7037 |
Pos airway pressure tubing |
25 |
24 |
$344.96 |