| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
3,904 |
3,233 |
$277K |
| K0738 |
Portable gas oxygen system |
1,339 |
1,139 |
$33K |
| E0431 |
Portable gaseous 02 |
1,139 |
956 |
$13K |
| A4604 |
Tubing with heating element |
445 |
373 |
$12K |
| E0601 |
Cont airway pressure device |
463 |
306 |
$8K |
| A7031 |
Replacement facemask interfa |
213 |
146 |
$6K |
| A7038 |
Pos airway pressure filter |
962 |
713 |
$4K |
| A7030 |
Cpap full face mask |
53 |
40 |
$3K |
| A7034 |
Nasal application device |
28 |
26 |
$2K |
| A7035 |
Pos airway press headgear |
51 |
40 |
$985.49 |
| E1392 |
Portable oxygen concentrator |
65 |
48 |
$985.35 |
| A7032 |
Replacement nasal cushion |
39 |
26 |
$980.98 |
| A7046 |
Repl water chamber, pap dev |
76 |
64 |
$702.86 |