| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
1,968 |
1,900 |
$176K |
| A4604 |
Tubing with heating element |
1,266 |
1,236 |
$45K |
| A7030 |
Cpap full face mask |
444 |
431 |
$43K |
| A7034 |
Nasal application device |
617 |
599 |
$38K |
| S9999 |
Sales tax |
1,720 |
1,488 |
$35K |
| A7035 |
Pos airway press headgear |
1,289 |
1,239 |
$27K |
| A7038 |
Pos airway pressure filter |
2,178 |
2,075 |
$14K |
| E0562 |
Humidifier heated used w pap |
66 |
65 |
$11K |
| A7046 |
Repl water chamber, pap dev |
848 |
829 |
$7K |
| A7031 |
Replacement facemask interfa |
217 |
207 |
$6K |
| A7032 |
Replacement nasal cushion |
137 |
130 |
$4K |
| A7039 |
Filter, non disposable w pap |
75 |
75 |
$696.30 |
| A7033 |
Replacement nasal pillows |
26 |
25 |
$422.20 |
| A7045 |
Repl exhalation port for pap |
347 |
338 |
$271.16 |
| A9279 |
Monitoring feature/devicenoc |
37 |
37 |
$59.94 |