| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
5,694 |
5,668 |
$278K |
| E0431 |
Portable gaseous 02 |
3,159 |
3,144 |
$25K |
| A7031 |
Replacement facemask interfa |
306 |
303 |
$11K |
| A7030 |
Cpap full face mask |
118 |
117 |
$6K |
| A7038 |
Pos airway pressure filter |
1,069 |
1,054 |
$3K |
| E0570 |
Nebulizer with compression |
491 |
491 |
$2K |
| A7035 |
Pos airway press headgear |
138 |
137 |
$1K |
| A7037 |
Pos airway pressure tubing |
212 |
210 |
$1K |
| E0562 |
Humidifier heated used w pap |
143 |
143 |
$540.68 |
| E0601 |
Cont airway pressure device |
12 |
12 |
$252.46 |
| A7046 |
Repl water chamber, pap dev |
26 |
25 |
$99.13 |