| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,093 |
2,878 |
$193K |
| K0738 |
Portable gas oxygen system |
1,794 |
1,734 |
$43K |
| E0441 |
Stationary o2 contents, gas |
881 |
832 |
$42K |
| E0601 |
Cont airway pressure device |
156 |
151 |
$12K |
| A7030 |
Cpap full face mask |
40 |
40 |
$4K |
| A4604 |
Tubing with heating element |
65 |
65 |
$2K |
| E0430 |
Oxygen system gas portable |
85 |
85 |
$2K |
| A7038 |
Pos airway pressure filter |
292 |
275 |
$2K |
| A7031 |
Replacement facemask interfa |
26 |
26 |
$1K |
| A7035 |
Pos airway press headgear |
20 |
20 |
$528.32 |
| A7046 |
Repl water chamber, pap dev |
15 |
15 |
$256.00 |