| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,460 |
3,267 |
$258K |
| E0601 |
Cont airway pressure device |
1,424 |
1,384 |
$80K |
| E0431 |
Portable gaseous 02 |
787 |
730 |
$13K |
| E0562 |
Humidifier heated used w pap |
229 |
208 |
$6K |
| A7038 |
Pos airway pressure filter |
427 |
420 |
$2K |
| K0738 |
Portable gas oxygen system |
38 |
38 |
$998.68 |
| A7035 |
Pos airway press headgear |
37 |
37 |
$977.63 |
| A4604 |
Tubing with heating element |
37 |
37 |
$856.07 |
| A7046 |
Repl water chamber, pap dev |
63 |
61 |
$578.48 |
| A7039 |
Filter, non disposable w pap |
40 |
39 |
$307.35 |