| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
10,430 |
7,227 |
$408K |
| A7031 |
Replacement facemask interfa |
1,307 |
1,041 |
$49K |
| E0431 |
Portable gaseous 02 |
5,325 |
3,831 |
$48K |
| A7030 |
Cpap full face mask |
703 |
521 |
$37K |
| A7038 |
Pos airway pressure filter |
2,407 |
1,873 |
$11K |
| E0601 |
Cont airway pressure device |
265 |
184 |
$9K |
| B4035 |
Enteral feed supp pump per d |
38 |
24 |
$7K |
| A4604 |
Tubing with heating element |
484 |
336 |
$6K |
| E0562 |
Humidifier heated used w pap |
375 |
273 |
$5K |
| A7035 |
Pos airway press headgear |
416 |
299 |
$4K |
| A7037 |
Pos airway pressure tubing |
87 |
69 |
$1K |
| A7046 |
Repl water chamber, pap dev |
270 |
189 |
$1K |
| A7034 |
Nasal application device |
32 |
24 |
$911.62 |