| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
7,476 |
6,032 |
$268K |
| E0601 |
Cont airway pressure device |
1,821 |
1,471 |
$39K |
| E0431 |
Portable gaseous 02 |
5,170 |
4,175 |
$21K |
| E0570 |
Nebulizer with compression |
1,382 |
1,125 |
$15K |
| K0001 |
Standard wheelchair |
1,102 |
821 |
$8K |
| E0260 |
Hosp bed semi-electr w/ matt |
95 |
67 |
$7K |
| E0562 |
Humidifier heated used w pap |
1,140 |
929 |
$3K |
| E0261 |
Hosp bed semi-electr w/o mat |
358 |
291 |
$594.13 |
| A7030 |
Cpap full face mask |
101 |
84 |
$502.14 |
| A7038 |
Pos airway pressure filter |
445 |
358 |
$73.20 |
| A7031 |
Replacement facemask interfa |
101 |
84 |
$49.83 |
| A7034 |
Nasal application device |
68 |
54 |
$33.11 |
| A7035 |
Pos airway press headgear |
179 |
150 |
$26.39 |
| A7046 |
Repl water chamber, pap dev |
36 |
30 |
$12.12 |
| A7039 |
Filter, non disposable w pap |
59 |
50 |
$6.27 |
| A7037 |
Pos airway pressure tubing |
427 |
352 |
$5.63 |