| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
1,353 |
1,309 |
$142K |
| A7030 |
Cpap full face mask |
577 |
554 |
$41K |
| A4604 |
Tubing with heating element |
1,179 |
1,132 |
$36K |
| S9999 |
Sales tax |
934 |
809 |
$26K |
| A7034 |
Nasal application device |
429 |
415 |
$20K |
| A7035 |
Pos airway press headgear |
956 |
931 |
$20K |
| A7031 |
Replacement facemask interfa |
864 |
734 |
$16K |
| A7038 |
Pos airway pressure filter |
2,687 |
2,424 |
$14K |
| A7032 |
Replacement nasal cushion |
316 |
285 |
$7K |
| E1390 |
Oxygen concentrator |
85 |
85 |
$4K |
| A7046 |
Repl water chamber, pap dev |
554 |
536 |
$4K |
| E0562 |
Humidifier heated used w pap |
17 |
17 |
$2K |
| A7033 |
Replacement nasal pillows |
91 |
84 |
$2K |
| A7039 |
Filter, non disposable w pap |
91 |
84 |
$795.38 |