| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,852 |
5,473 |
$417K |
| E0439 |
Stationary liquid 02 |
2,105 |
1,979 |
$173K |
| E0442 |
Stationary o2 contents, liq |
2,506 |
2,102 |
$108K |
| E0434 |
Portable liquid 02 |
2,207 |
2,075 |
$62K |
| E0431 |
Portable gaseous 02 |
2,454 |
2,316 |
$37K |
| E0601 |
Cont airway pressure device |
513 |
457 |
$29K |
| E1392 |
Portable oxygen concentrator |
726 |
647 |
$13K |
| A7037 |
Pos airway pressure tubing |
263 |
244 |
$4K |
| A7031 |
Replacement facemask interfa |
44 |
39 |
$1K |
| A7038 |
Pos airway pressure filter |
322 |
273 |
$1K |
| A7035 |
Pos airway press headgear |
77 |
72 |
$910.86 |
| A7030 |
Cpap full face mask |
15 |
14 |
$742.49 |
| A7034 |
Nasal application device |
14 |
12 |
$175.92 |
| A7039 |
Filter, non disposable w pap |
31 |
29 |
$103.41 |