| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A7030 |
Cpap full face mask |
3,034 |
2,149 |
$105K |
| E0601 |
Cont airway pressure device |
4,905 |
3,510 |
$99K |
| E1390 |
Oxygen concentrator |
3,663 |
2,882 |
$90K |
| A7034 |
Nasal application device |
2,083 |
1,516 |
$50K |
| A4604 |
Tubing with heating element |
2,673 |
1,969 |
$48K |
| E0562 |
Humidifier heated used w pap |
4,191 |
2,258 |
$41K |
| A7031 |
Replacement facemask interfa |
2,491 |
1,682 |
$34K |
| A7035 |
Pos airway press headgear |
3,465 |
2,554 |
$30K |
| K0738 |
Portable gas oxygen system |
1,306 |
1,139 |
$18K |
| A7032 |
Replacement nasal cushion |
869 |
637 |
$15K |
| A7038 |
Pos airway pressure filter |
4,902 |
3,575 |
$10K |
| A7037 |
Pos airway pressure tubing |
2,238 |
1,623 |
$10K |
| A7046 |
Repl water chamber, pap dev |
1,918 |
1,423 |
$10K |
| E1392 |
Portable oxygen concentrator |
139 |
121 |
$1K |
| A7039 |
Filter, non disposable w pap |
342 |
260 |
$1K |
| E0431 |
Portable gaseous 02 |
65 |
51 |
$448.63 |
| A7036 |
Pos airway press chinstrap |
14 |
12 |
$87.03 |