| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,404 |
7,673 |
$229K |
| E0601 |
Cont airway pressure device |
1,403 |
1,226 |
$25K |
| E0431 |
Portable gaseous 02 |
4,431 |
4,083 |
$24K |
| E0570 |
Nebulizer with compression |
4,914 |
4,300 |
$21K |
| K0001 |
Standard wheelchair |
2,804 |
2,310 |
$19K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,170 |
989 |
$17K |
| E0562 |
Humidifier heated used w pap |
1,879 |
1,651 |
$10K |
| A5512 |
Multi den insert direct form |
208 |
124 |
$5K |
| A5500 |
Diab shoe for density insert |
208 |
124 |
$4K |
| A7038 |
Pos airway pressure filter |
463 |
402 |
$1K |
| A7005 |
Nondisposable nebulizer set |
120 |
114 |
$1K |
| A7035 |
Pos airway press headgear |
53 |
39 |
$575.90 |
| A7031 |
Replacement facemask interfa |
28 |
26 |
$386.83 |
| E0114 |
Crutch underarm pair no wood |
15 |
13 |
$312.89 |