| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,174 |
918 |
$15K |
| A7031 |
Replacement facemask interfa |
1,243 |
1,012 |
$14K |
| A7030 |
Cpap full face mask |
1,221 |
998 |
$13K |
| A7032 |
Replacement nasal cushion |
583 |
457 |
$8K |
| A7034 |
Nasal application device |
933 |
779 |
$8K |
| A4604 |
Tubing with heating element |
1,153 |
948 |
$6K |
| A7038 |
Pos airway pressure filter |
2,180 |
1,807 |
$4K |
| A7035 |
Pos airway press headgear |
1,228 |
1,022 |
$4K |
| E0601 |
Cont airway pressure device |
603 |
480 |
$3K |
| A7033 |
Replacement nasal pillows |
222 |
190 |
$3K |
| A7037 |
Pos airway pressure tubing |
998 |
824 |
$2K |
| A7046 |
Repl water chamber, pap dev |
1,077 |
903 |
$2K |
| E0431 |
Portable gaseous 02 |
437 |
352 |
$2K |
| E0470 |
Rad w/o backup non-inv intfc |
50 |
50 |
$2K |
| A7039 |
Filter, non disposable w pap |
841 |
720 |
$842.64 |
| A7036 |
Pos airway press chinstrap |
12 |
12 |
$3.77 |