| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,954 |
6,063 |
$210K |
| E0601 |
Cont airway pressure device |
2,602 |
2,329 |
$73K |
| E0570 |
Nebulizer with compression |
2,080 |
1,718 |
$42K |
| E0431 |
Portable gaseous 02 |
4,644 |
4,001 |
$29K |
| E0562 |
Humidifier heated used w pap |
1,044 |
962 |
$23K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,004 |
863 |
$17K |
| K0004 |
High strength ltwt whlchr |
430 |
397 |
$8K |
| K0003 |
Lightweight wheelchair |
570 |
477 |
$8K |
| A7031 |
Replacement facemask interfa |
110 |
103 |
$2K |
| K0001 |
Standard wheelchair |
245 |
210 |
$2K |
| A4604 |
Tubing with heating element |
55 |
50 |
$1K |
| E0973 |
W/ch access det adj armrest |
579 |
277 |
$1K |
| A7035 |
Pos airway press headgear |
95 |
89 |
$893.52 |
| A7030 |
Cpap full face mask |
15 |
15 |
$593.59 |
| A7005 |
Nondisposable nebulizer set |
74 |
68 |
$531.21 |
| A7038 |
Pos airway pressure filter |
231 |
210 |
$496.27 |
| E0114 |
Crutch underarm pair no wood |
13 |
12 |
$417.10 |
| A7039 |
Filter, non disposable w pap |
12 |
12 |
$44.02 |
| A7003 |
Nebulizer administration set |
26 |
25 |
$35.10 |