| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
18,153 |
16,728 |
$972K |
| E0424 |
Stationary compressed gas 02 |
3,466 |
3,391 |
$241K |
| E0431 |
Portable gaseous 02 |
15,730 |
14,900 |
$214K |
| E0441 |
Stationary o2 contents, gas |
1,626 |
1,605 |
$80K |
| E0601 |
Cont airway pressure device |
1,127 |
984 |
$45K |
| A7030 |
Cpap full face mask |
361 |
302 |
$15K |
| A7037 |
Pos airway pressure tubing |
759 |
699 |
$8K |
| A7031 |
Replacement facemask interfa |
401 |
328 |
$8K |
| A7038 |
Pos airway pressure filter |
1,563 |
1,414 |
$5K |
| E1392 |
Portable oxygen concentrator |
621 |
476 |
$4K |
| E0562 |
Humidifier heated used w pap |
27 |
26 |
$3K |
| A7035 |
Pos airway press headgear |
277 |
216 |
$2K |
| K0738 |
Portable gas oxygen system |
252 |
166 |
$1K |
| A7046 |
Repl water chamber, pap dev |
167 |
132 |
$779.20 |
| A7034 |
Nasal application device |
33 |
26 |
$778.07 |
| E0570 |
Nebulizer with compression |
24 |
24 |
$304.89 |
| K0001 |
Standard wheelchair |
136 |
130 |
$195.57 |
| A7039 |
Filter, non disposable w pap |
14 |
12 |
$71.24 |
| A4615 |
Cannula nasal |
216 |
196 |
$3.65 |
| A9900 |
Supply/accessory/service |
22 |
13 |
$0.00 |