| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
7,673 |
6,374 |
$262K |
| E0601 |
Cont airway pressure device |
2,111 |
1,860 |
$65K |
| E0470 |
Rad w/o backup non-inv intfc |
767 |
656 |
$43K |
| A7031 |
Replacement facemask interfa |
2,020 |
1,746 |
$41K |
| K0738 |
Portable gas oxygen system |
2,403 |
2,049 |
$39K |
| E0431 |
Portable gaseous 02 |
3,401 |
2,855 |
$26K |
| E0562 |
Humidifier heated used w pap |
3,157 |
2,758 |
$26K |
| A7035 |
Pos airway press headgear |
1,024 |
863 |
$9K |
| T4541 |
Large disposable underpad |
196 |
168 |
$9K |
| A7037 |
Pos airway pressure tubing |
1,296 |
1,103 |
$9K |
| A7030 |
Cpap full face mask |
152 |
134 |
$7K |
| T4528 |
Adult size pull-on xl |
32 |
26 |
$4K |
| A7038 |
Pos airway pressure filter |
1,561 |
1,324 |
$3K |
| A7032 |
Replacement nasal cushion |
184 |
154 |
$3K |
| A7039 |
Filter, non disposable w pap |
529 |
440 |
$2K |
| A7046 |
Repl water chamber, pap dev |
163 |
142 |
$905.01 |
| A4604 |
Tubing with heating element |
17 |
16 |
$554.63 |