| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,199 |
3,255 |
$56K |
| E0601 |
Cont airway pressure device |
726 |
589 |
$18K |
| E0431 |
Portable gaseous 02 |
3,242 |
2,439 |
$14K |
| E0260 |
Hosp bed semi-electr w/ matt |
450 |
355 |
$10K |
| K0003 |
Lightweight wheelchair |
490 |
404 |
$8K |
| A7031 |
Replacement facemask interfa |
247 |
208 |
$7K |
| E0570 |
Nebulizer with compression |
918 |
708 |
$5K |
| A7030 |
Cpap full face mask |
62 |
45 |
$2K |
| K0001 |
Standard wheelchair |
151 |
111 |
$2K |
| A7038 |
Pos airway pressure filter |
524 |
469 |
$1K |
| A7032 |
Replacement nasal cushion |
39 |
38 |
$1K |
| A7035 |
Pos airway press headgear |
52 |
43 |
$585.47 |
| A4604 |
Tubing with heating element |
30 |
25 |
$464.51 |
| E1392 |
Portable oxygen concentrator |
63 |
58 |
$452.44 |