| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,316 |
3,001 |
$103K |
| E1392 |
Portable oxygen concentrator |
1,967 |
1,300 |
$15K |
| A7031 |
Replacement facemask interfa |
722 |
410 |
$12K |
| A7030 |
Cpap full face mask |
239 |
167 |
$10K |
| E0601 |
Cont airway pressure device |
486 |
342 |
$9K |
| E0431 |
Portable gaseous 02 |
1,569 |
1,133 |
$8K |
| E0570 |
Nebulizer with compression |
720 |
562 |
$6K |
| A7038 |
Pos airway pressure filter |
1,184 |
699 |
$3K |
| K0001 |
Standard wheelchair |
250 |
236 |
$2K |
| A7037 |
Pos airway pressure tubing |
73 |
52 |
$743.27 |
| A7035 |
Pos airway press headgear |
35 |
25 |
$312.57 |
| A7005 |
Nondisposable nebulizer set |
26 |
24 |
$183.92 |
| A7013 |
Disposable compressor filter |
26 |
24 |
$29.24 |