| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,916 |
4,827 |
$434K |
| E0601 |
Cont airway pressure device |
875 |
714 |
$54K |
| A7030 |
Cpap full face mask |
554 |
456 |
$34K |
| E0431 |
Portable gaseous 02 |
2,433 |
2,035 |
$33K |
| E1392 |
Portable oxygen concentrator |
1,158 |
859 |
$22K |
| E0439 |
Stationary liquid 02 |
257 |
205 |
$22K |
| A7031 |
Replacement facemask interfa |
829 |
661 |
$20K |
| A7034 |
Nasal application device |
246 |
184 |
$7K |
| A4604 |
Tubing with heating element |
412 |
312 |
$7K |
| A7038 |
Pos airway pressure filter |
1,875 |
1,444 |
$6K |
| E0434 |
Portable liquid 02 |
205 |
161 |
$6K |
| A7035 |
Pos airway press headgear |
404 |
333 |
$5K |
| K0738 |
Portable gas oxygen system |
165 |
146 |
$5K |
| A7032 |
Replacement nasal cushion |
244 |
175 |
$3K |
| A7046 |
Repl water chamber, pap dev |
216 |
170 |
$2K |
| A7037 |
Pos airway pressure tubing |
65 |
52 |
$625.57 |