Category: OXYGEN SYSTEM & RELATED

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  COVERED ITEMS/FORMULARY

  CGA 870 Oxygen Regulator – 0-15 LPM

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  Chrome Oxygen Cylinder Cart

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  OXYGEN SYSTEM & RELATED

  Drive Cozy Cannula

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  OXYGEN SYSTEM & RELATED

  Drive No-Kink Oxygen Tubing

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  COVERED ITEMS/FORMULARY

  Drive Oxygen Regulator – 0 -15 LPM

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  COVERED ITEMS/FORMULARY

  Drive Suction Unit

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  NON COVERED ITEMS/NON-FORMULARY (STANDARD)

  DynaRest Alternating Pressure Pump and Pad System

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  OXYGEN SYSTEM & RELATED

  Dynarex Aerosol Elongated Adult Masks

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  OXYGEN SYSTEM & RELATED

  Dynarex Dry Bubble Humidier

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  OXYGEN SYSTEM & RELATED

  Dynarex Oxygen Supply Tubing 7″

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  Dynarex Oxygen Tank Cart

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  OXYGEN SYSTEM & RELATED

  Dynarex Oxygen Tubing 5-7mm End Adapter

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