| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,793 |
3,395 |
$134K |
| K0738 |
Portable gas oxygen system |
1,535 |
1,406 |
$75K |
| E0601 |
Cont airway pressure device |
1,179 |
901 |
$25K |
| E0570 |
Nebulizer with compression |
406 |
386 |
$13K |
| E0562 |
Humidifier heated used w pap |
153 |
124 |
$4K |
| A7037 |
Pos airway pressure tubing |
59 |
53 |
$1K |
| A7031 |
Replacement facemask interfa |
43 |
37 |
$1K |
| A7035 |
Pos airway press headgear |
44 |
37 |
$962.18 |
| E0431 |
Portable gaseous 02 |
98 |
83 |
$757.30 |
| K0001 |
Standard wheelchair |
60 |
54 |
$728.62 |
| A4604 |
Tubing with heating element |
54 |
46 |
$598.41 |
| E1392 |
Portable oxygen concentrator |
71 |
53 |
$313.40 |
| A7038 |
Pos airway pressure filter |
65 |
58 |
$245.63 |
| A7046 |
Repl water chamber, pap dev |
15 |
12 |
$129.03 |