| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
51 |
50 |
$6K |
| A7030 |
Full face mask used with positive airway pressure device, each |
17 |
17 |
$2K |
| A7031 |
Face mask interface, replacement for full face mask, each |
43 |
43 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
17 |
17 |
$868.53 |
| A7035 |
Headgear used with positive airway pressure device |
16 |
16 |
$486.24 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
43 |
43 |
$346.92 |
| A7036 |
Chinstrap used with positive airway pressure device |
14 |
14 |
$194.74 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
13 |
13 |
$193.96 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
13 |
13 |
$152.36 |