| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
3,156 |
2,443 |
$148K |
| E1390 |
Oxygen concentrator |
2,009 |
1,431 |
$120K |
| E0570 |
Nebulizer with compression |
572 |
530 |
$58K |
| E0562 |
Humidifier heated used w pap |
1,912 |
1,349 |
$49K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,348 |
1,294 |
$31K |
| A4627 |
Spacer bag/reservoir |
685 |
666 |
$24K |
| A7030 |
Cpap full face mask |
302 |
227 |
$23K |
| A7035 |
Pos airway press headgear |
1,221 |
899 |
$18K |
| A7034 |
Nasal application device |
415 |
283 |
$17K |
| K0738 |
Portable gas oxygen system |
846 |
567 |
$12K |
| A7031 |
Replacement facemask interfa |
297 |
234 |
$10K |
| A4604 |
Tubing with heating element |
422 |
319 |
$7K |
| A7037 |
Pos airway pressure tubing |
321 |
244 |
$7K |
| A7038 |
Pos airway pressure filter |
2,151 |
1,567 |
$7K |
| A4554 |
Disposable underpads |
131 |
111 |
$6K |
| K0001 |
Standard wheelchair |
593 |
362 |
$4K |
| A4927 |
Non-sterile gloves |
60 |
54 |
$598.37 |
| A7032 |
Replacement nasal cushion |
17 |
14 |
$588.17 |
| A7046 |
Repl water chamber, pap dev |
32 |
27 |
$241.67 |