| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
476 |
462 |
$35K |
| A7031 |
Replacement facemask interfa |
488 |
484 |
$24K |
| A7030 |
Cpap full face mask |
116 |
116 |
$15K |
| A7037 |
Pos airway pressure tubing |
231 |
230 |
$6K |
| A7038 |
Pos airway pressure filter |
702 |
695 |
$4K |
| E0562 |
Humidifier heated used w pap |
21 |
21 |
$4K |
| A7035 |
Pos airway press headgear |
98 |
98 |
$2K |
| A7032 |
Replacement nasal cushion |
25 |
25 |
$1K |
| A7034 |
Nasal application device |
12 |
12 |
$942.84 |
| A5500 |
Diab shoe for density insert |
40 |
19 |
$754.84 |
| A5512 |
Multi den insert direct form |
40 |
19 |
$578.40 |