| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
7,432 |
6,374 |
$412K |
| E0601 |
Cont airway pressure device |
3,132 |
2,440 |
$111K |
| E0431 |
Portable gaseous 02 |
5,785 |
4,989 |
$75K |
| K0001 |
Standard wheelchair |
2,270 |
1,808 |
$43K |
| A7030 |
Cpap full face mask |
419 |
350 |
$31K |
| E0570 |
Nebulizer with compression |
1,825 |
1,500 |
$16K |
| E0261 |
Hosp bed semi-electr w/o mat |
476 |
343 |
$14K |
| K0003 |
Lightweight wheelchair |
459 |
310 |
$13K |
| A7037 |
Pos airway pressure tubing |
758 |
659 |
$11K |
| A7031 |
Replacement facemask interfa |
313 |
255 |
$10K |
| E0562 |
Humidifier heated used w pap |
160 |
126 |
$8K |
| A7038 |
Pos airway pressure filter |
1,214 |
1,066 |
$8K |
| K0195 |
Elevating whlchair leg rests |
1,254 |
974 |
$7K |
| A7035 |
Pos airway press headgear |
445 |
371 |
$6K |
| A7034 |
Nasal application device |
67 |
63 |
$3K |
| E1392 |
Portable oxygen concentrator |
141 |
124 |
$673.36 |
| A7046 |
Repl water chamber, pap dev |
86 |
78 |
$651.73 |
| E0143 |
Walker folding wheeled w/o s |
17 |
15 |
$173.75 |
| A7039 |
Filter, non disposable w pap |
14 |
14 |
$90.27 |
| A9279 |
Monitoring feature/devicenoc |
124 |
121 |
$0.00 |