| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
279 |
278 |
$13K |
| A7030 |
Cpap full face mask |
60 |
59 |
$3K |
| A7031 |
Replacement facemask interfa |
89 |
87 |
$2K |
| A7034 |
Nasal application device |
67 |
66 |
$2K |
| E0601 |
Cont airway pressure device |
64 |
63 |
$2K |
| A4604 |
Tubing with heating element |
98 |
98 |
$2K |
| E0431 |
Portable gaseous 02 |
146 |
146 |
$1K |
| A7032 |
Replacement nasal cushion |
26 |
26 |
$1K |
| E1392 |
Portable oxygen concentrator |
72 |
72 |
$973.25 |
| A7038 |
Pos airway pressure filter |
249 |
243 |
$919.36 |
| A7035 |
Pos airway press headgear |
101 |
100 |
$806.11 |
| A7046 |
Repl water chamber, pap dev |
69 |
69 |
$281.31 |
| E0570 |
Nebulizer with compression |
12 |
12 |
$213.66 |
| A7039 |
Filter, non disposable w pap |
74 |
72 |
$181.25 |