| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
2,633 |
2,433 |
$79K |
| A4604 |
Tubing with heating element |
2,120 |
1,964 |
$61K |
| A7030 |
Cpap full face mask |
726 |
681 |
$59K |
| E1390 |
Oxygen concentrator |
1,163 |
1,074 |
$52K |
| A7031 |
Replacement facemask interfa |
1,404 |
1,320 |
$50K |
| E0570 |
Nebulizer with compression |
1,991 |
1,777 |
$39K |
| A7035 |
Pos airway press headgear |
1,331 |
1,231 |
$20K |
| A7034 |
Nasal application device |
389 |
353 |
$20K |
| A7038 |
Pos airway pressure filter |
3,160 |
2,913 |
$15K |
| A7032 |
Replacement nasal cushion |
238 |
217 |
$10K |
| A7046 |
Repl water chamber, pap dev |
424 |
395 |
$4K |
| E0562 |
Humidifier heated used w pap |
58 |
43 |
$4K |
| A7039 |
Filter, non disposable w pap |
361 |
344 |
$2K |
| A7033 |
Replacement nasal pillows |
42 |
38 |
$976.82 |
| E0431 |
Portable gaseous 02 |
138 |
133 |
$930.02 |
| A7005 |
Nondisposable nebulizer set |
40 |
39 |
$598.55 |
| S9999 |
Sales tax |
46 |
45 |
$366.01 |
| A7015 |
Aerosol mask used w nebulize |
12 |
12 |
$17.76 |