| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,947 |
6,833 |
$426K |
| K0738 |
Portable gas oxygen system |
2,873 |
2,835 |
$112K |
| E0466 |
Home vent non-invasive inter |
141 |
130 |
$75K |
| E0601 |
Cont airway pressure device |
1,623 |
1,593 |
$58K |
| E0431 |
Portable gaseous 02 |
1,822 |
1,755 |
$49K |
| A7030 |
Cpap full face mask |
325 |
314 |
$25K |
| A7034 |
Nasal application device |
389 |
370 |
$19K |
| A7037 |
Pos airway pressure tubing |
1,022 |
980 |
$11K |
| A7035 |
Pos airway press headgear |
640 |
614 |
$10K |
| A7038 |
Pos airway pressure filter |
1,306 |
1,250 |
$5K |
| A7046 |
Repl water chamber, pap dev |
262 |
252 |
$3K |
| A7031 |
Replacement facemask interfa |
64 |
61 |
$2K |
| K0001 |
Standard wheelchair |
75 |
72 |
$1K |
| A7032 |
Replacement nasal cushion |
25 |
24 |
$628.23 |