| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,135 |
3,689 |
$155K |
| E0601 |
Cont airway pressure device |
1,799 |
1,665 |
$51K |
| E0431 |
Portable gaseous 02 |
2,458 |
2,212 |
$16K |
| E0260 |
Hosp bed semi-electr w/ matt |
385 |
353 |
$10K |
| E0562 |
Humidifier heated used w pap |
378 |
319 |
$9K |
| E0466 |
Home vent non-invasive inter |
15 |
12 |
$7K |
| K0001 |
Standard wheelchair |
557 |
537 |
$6K |
| E0570 |
Nebulizer with compression |
1,137 |
1,068 |
$6K |
| A4604 |
Tubing with heating element |
132 |
115 |
$2K |
| E0470 |
Rad w/o backup non-inv intfc |
24 |
24 |
$2K |
| A7031 |
Replacement facemask interfa |
96 |
84 |
$1K |
| A7030 |
Cpap full face mask |
32 |
30 |
$984.15 |
| A7038 |
Pos airway pressure filter |
409 |
358 |
$845.48 |
| A7035 |
Pos airway press headgear |
73 |
65 |
$537.58 |
| K0003 |
Lightweight wheelchair |
13 |
13 |
$236.59 |
| E1392 |
Portable oxygen concentrator |
32 |
30 |
$65.08 |
| A7005 |
Nondisposable nebulizer set |
14 |
12 |
$26.53 |