| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,619 |
3,591 |
$197K |
| E0601 |
Cont airway pressure device |
1,089 |
1,071 |
$34K |
| E0431 |
Portable gaseous 02 |
2,642 |
2,619 |
$28K |
| L3660 |
So 8 ab rstr can/web pre ots |
502 |
486 |
$20K |
| E0114 |
Crutch underarm pair no wood |
678 |
661 |
$15K |
| E0260 |
Hosp bed semi-electr w/ matt |
512 |
507 |
$13K |
| A7031 |
Replacement facemask interfa |
412 |
403 |
$11K |
| K0001 |
Standard wheelchair |
679 |
667 |
$9K |
| A7030 |
Cpap full face mask |
145 |
145 |
$7K |
| E0466 |
Home vent non-invasive inter |
12 |
12 |
$6K |
| A7038 |
Pos airway pressure filter |
1,184 |
1,171 |
$5K |
| A7035 |
Pos airway press headgear |
153 |
152 |
$2K |
| A7034 |
Nasal application device |
49 |
49 |
$2K |
| E0562 |
Humidifier heated used w pap |
51 |
51 |
$1K |
| E0630 |
Patient lift hydraulic |
74 |
73 |
$1K |
| A7037 |
Pos airway pressure tubing |
98 |
98 |
$1K |
| E0570 |
Nebulizer with compression |
104 |
103 |
$558.62 |
| L1830 |
Ko immob canvas long pre ots |
12 |
12 |
$258.24 |
| L3908 |
Who cock-up nonmolde pre ots |
14 |
14 |
$244.80 |
| A4604 |
Tubing with heating element |
88 |
88 |
$146.38 |