| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
376 |
371 |
$26K |
| E0601 |
Cont airway pressure device |
518 |
470 |
$23K |
| A7030 |
Cpap full face mask |
140 |
127 |
$9K |
| A7034 |
Nasal application device |
132 |
117 |
$6K |
| A7037 |
Pos airway pressure tubing |
288 |
262 |
$4K |
| A7031 |
Replacement facemask interfa |
126 |
110 |
$3K |
| A7032 |
Replacement nasal cushion |
77 |
68 |
$3K |
| A7035 |
Pos airway press headgear |
209 |
185 |
$3K |
| A7038 |
Pos airway pressure filter |
598 |
548 |
$2K |
| A7039 |
Filter, non disposable w pap |
193 |
171 |
$1K |
| A7046 |
Repl water chamber, pap dev |
140 |
124 |
$1K |
| E0431 |
Portable gaseous 02 |
52 |
52 |
$809.03 |
| A7033 |
Replacement nasal pillows |
12 |
12 |
$262.83 |
| K0001 |
Standard wheelchair |
12 |
12 |
$83.03 |