| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A7030 |
Cpap full face mask |
2,106 |
1,874 |
$169K |
| E1390 |
Oxygen concentrator |
2,493 |
2,188 |
$158K |
| E0601 |
Cont airway pressure device |
2,566 |
2,315 |
$134K |
| A7031 |
Replacement facemask interfa |
1,844 |
1,661 |
$62K |
| E0470 |
Rad w/o backup non-inv intfc |
312 |
277 |
$37K |
| A7035 |
Pos airway press headgear |
1,540 |
1,378 |
$26K |
| A4604 |
Tubing with heating element |
1,570 |
1,409 |
$18K |
| A7038 |
Pos airway pressure filter |
3,073 |
2,784 |
$16K |
| A7034 |
Nasal application device |
254 |
237 |
$12K |
| A7032 |
Replacement nasal cushion |
239 |
223 |
$7K |
| A7046 |
Repl water chamber, pap dev |
732 |
661 |
$7K |
| E0570 |
Nebulizer with compression |
36 |
30 |
$3K |
| A7037 |
Pos airway pressure tubing |
659 |
586 |
$2K |
| E0431 |
Portable gaseous 02 |
70 |
65 |
$1K |
| T4527 |
Adult size pull-on lg |
13 |
12 |
$1K |
| A7039 |
Filter, non disposable w pap |
124 |
104 |
$954.87 |
| A7033 |
Replacement nasal pillows |
31 |
25 |
$783.44 |
| E1392 |
Portable oxygen concentrator |
104 |
85 |
$329.88 |
| K0738 |
Portable gas oxygen system |
12 |
12 |
$261.14 |