| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
216 |
216 |
$12K |
| E0601 |
Continuous positive airway pressure (cpap) device |
179 |
179 |
$8K |
| A4927 |
Gloves, non-sterile, per 100 |
199 |
146 |
$3K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
66 |
66 |
$1K |