| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
9,527 |
7,136 |
$312K |
| E0431 |
Portable gaseous 02 |
6,324 |
4,767 |
$41K |
| K0001 |
Standard wheelchair |
1,109 |
914 |
$19K |
| E0570 |
Nebulizer with compression |
1,353 |
1,086 |
$18K |
| E0601 |
Cont airway pressure device |
806 |
636 |
$15K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,279 |
946 |
$11K |
| E0562 |
Humidifier heated used w pap |
940 |
753 |
$6K |
| K0823 |
Pwc gp 2 std cap chair |
30 |
14 |
$5K |
| A4604 |
Tubing with heating element |
84 |
78 |
$1K |
| A7038 |
Pos airway pressure filter |
351 |
316 |
$1K |
| A7035 |
Pos airway press headgear |
74 |
67 |
$906.48 |
| A7030 |
Cpap full face mask |
13 |
12 |
$552.53 |
| A7031 |
Replacement facemask interfa |
19 |
16 |
$321.64 |
| A7003 |
Nebulizer administration set |
101 |
79 |
$114.74 |