| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,035 |
1,970 |
$84K |
| E0601 |
Cont airway pressure device |
973 |
890 |
$30K |
| A7030 |
Cpap full face mask |
420 |
398 |
$24K |
| A7031 |
Replacement facemask interfa |
1,029 |
976 |
$23K |
| E0260 |
Hosp bed semi-electr w/ matt |
380 |
369 |
$13K |
| A4604 |
Tubing with heating element |
548 |
522 |
$12K |
| A7038 |
Pos airway pressure filter |
1,697 |
1,623 |
$6K |
| K0001 |
Standard wheelchair |
573 |
549 |
$5K |
| A7034 |
Nasal application device |
126 |
122 |
$5K |
| A7032 |
Replacement nasal cushion |
136 |
134 |
$4K |
| A7035 |
Pos airway press headgear |
305 |
292 |
$4K |
| E0431 |
Portable gaseous 02 |
434 |
410 |
$3K |
| E0562 |
Humidifier heated used w pap |
186 |
159 |
$3K |
| K0738 |
Portable gas oxygen system |
99 |
94 |
$2K |
| A7046 |
Repl water chamber, pap dev |
292 |
275 |
$2K |
| K0195 |
Elevating whlchair leg rests |
161 |
150 |
$452.17 |
| A7039 |
Filter, non disposable w pap |
62 |
58 |
$348.74 |
| A7037 |
Pos airway pressure tubing |
13 |
13 |
$154.59 |
| E1392 |
Portable oxygen concentrator |
12 |
12 |
$22.78 |