| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A7031 |
Replacement facemask interfa |
259 |
237 |
$6K |
| E1390 |
Oxygen concentrator |
203 |
199 |
$6K |
| A4604 |
Tubing with heating element |
458 |
445 |
$6K |
| A7038 |
Pos airway pressure filter |
917 |
808 |
$3K |
| K0001 |
Standard wheelchair |
949 |
582 |
$3K |
| A7032 |
Replacement nasal cushion |
76 |
73 |
$2K |
| A7030 |
Cpap full face mask |
50 |
49 |
$2K |
| A7034 |
Nasal application device |
63 |
58 |
$1K |
| E0260 |
Hosp bed semi-electr w/ matt |
224 |
140 |
$1K |
| A7035 |
Pos airway press headgear |
115 |
114 |
$1K |
| E0601 |
Cont airway pressure device |
67 |
65 |
$632.90 |
| A7046 |
Repl water chamber, pap dev |
121 |
117 |
$587.70 |
| A7033 |
Replacement nasal pillows |
12 |
12 |
$210.54 |