| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,428 |
4,070 |
$354K |
| E0441 |
Stationary o2 contents, gas |
679 |
659 |
$36K |
| E0431 |
Portable gaseous 02 |
1,225 |
1,177 |
$19K |
| E0442 |
Stationary o2 contents, liq |
438 |
399 |
$18K |
| E0434 |
Portable liquid 02 |
438 |
415 |
$13K |
| K0738 |
Portable gas oxygen system |
420 |
399 |
$11K |
| E0601 |
Cont airway pressure device |
120 |
109 |
$8K |
| A7030 |
Cpap full face mask |
20 |
16 |
$1K |
| A4604 |
Tubing with heating element |
34 |
33 |
$1K |
| A7038 |
Pos airway pressure filter |
179 |
164 |
$1K |
| A7035 |
Pos airway press headgear |
34 |
33 |
$862.66 |
| A7031 |
Replacement facemask interfa |
20 |
16 |
$651.92 |
| A7046 |
Repl water chamber, pap dev |
23 |
18 |
$220.08 |