| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A7030 |
Cpap full face mask |
1,560 |
1,284 |
$38K |
| A7031 |
Replacement facemask interfa |
1,732 |
1,389 |
$35K |
| A4604 |
Tubing with heating element |
3,105 |
2,549 |
$33K |
| A7034 |
Nasal application device |
1,462 |
1,232 |
$22K |
| A7032 |
Replacement nasal cushion |
682 |
609 |
$21K |
| A7038 |
Pos airway pressure filter |
3,900 |
3,026 |
$13K |
| A7035 |
Pos airway press headgear |
1,818 |
1,476 |
$13K |
| E1390 |
Oxygen concentrator |
60 |
60 |
$10K |
| E0601 |
Cont airway pressure device |
485 |
384 |
$7K |
| A7526 |
Tracheostomy tube collar |
230 |
188 |
$7K |
| A7046 |
Repl water chamber, pap dev |
1,502 |
1,295 |
$5K |
| A7033 |
Replacement nasal pillows |
117 |
107 |
$3K |
| A7000 |
Disposable canister for pump |
151 |
72 |
$1K |
| A7002 |
Tubing used w suction pump |
229 |
109 |
$1K |
| A7039 |
Filter, non disposable w pap |
30 |
25 |
$59.67 |