| Code | Description | Claims | Beneficiaries | Total Paid |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
642 |
596 |
$47K |
| E0601 |
Continuous positive airway pressure (cpap) device |
91 |
91 |
$5K |
| E1392 |
Portable oxygen concentrator, rental |
139 |
125 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
70 |
70 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
12 |
12 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
14 |
14 |
$442.97 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
32 |
31 |
$183.19 |