| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,615 |
3,575 |
$128K |
| E0601 |
Cont airway pressure device |
1,834 |
1,829 |
$38K |
| K0738 |
Portable gas oxygen system |
1,279 |
1,267 |
$25K |
| E1392 |
Portable oxygen concentrator |
1,505 |
1,483 |
$19K |
| A7034 |
Nasal application device |
271 |
268 |
$8K |
| A4604 |
Tubing with heating element |
330 |
329 |
$7K |
| A7038 |
Pos airway pressure filter |
1,006 |
991 |
$6K |
| A7035 |
Pos airway press headgear |
408 |
405 |
$4K |
| A7030 |
Cpap full face mask |
51 |
51 |
$1K |
| A7039 |
Filter, non disposable w pap |
280 |
278 |
$1K |
| A7031 |
Replacement facemask interfa |
26 |
26 |
$753.15 |
| A7046 |
Repl water chamber, pap dev |
103 |
102 |
$517.28 |
| A7033 |
Replacement nasal pillows |
14 |
13 |
$389.02 |
| A7037 |
Pos airway pressure tubing |
38 |
38 |
$242.77 |
| E0143 |
Walker folding wheeled w/o s |
12 |
12 |
$199.81 |
| E0570 |
Nebulizer with compression |
136 |
136 |
$127.01 |
| K0052 |
Swingaway detach ftrest repl |
106 |
106 |
$0.00 |