| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,860 |
3,125 |
$139K |
| E0601 |
Cont airway pressure device |
652 |
559 |
$13K |
| E0431 |
Portable gaseous 02 |
1,539 |
1,318 |
$7K |
| E1392 |
Portable oxygen concentrator |
694 |
564 |
$3K |
| K0001 |
Standard wheelchair |
301 |
258 |
$767.82 |
| E0562 |
Humidifier heated used w pap |
44 |
37 |
$593.28 |
| E0570 |
Nebulizer with compression |
111 |
104 |
$352.85 |
| E0260 |
Hosp bed semi-electr w/ matt |
50 |
50 |
$271.02 |
| A7038 |
Pos airway pressure filter |
432 |
377 |
$28.74 |
| A4604 |
Tubing with heating element |
88 |
77 |
$0.00 |
| A7035 |
Pos airway press headgear |
28 |
24 |
$0.00 |
| A7031 |
Replacement facemask interfa |
73 |
69 |
$0.00 |