| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
2,569 |
2,389 |
$108K |
| E0562 |
Humidifier heated used w pap |
1,527 |
1,382 |
$30K |
| A5512 |
Multi den insert direct form |
485 |
344 |
$24K |
| A5500 |
Diab shoe for density insert |
489 |
345 |
$22K |
| A7034 |
Nasal application device |
479 |
466 |
$22K |
| E0570 |
Nebulizer with compression |
332 |
297 |
$16K |
| A7032 |
Replacement nasal cushion |
302 |
292 |
$9K |
| A7035 |
Pos airway press headgear |
456 |
439 |
$7K |
| A4604 |
Tubing with heating element |
204 |
197 |
$6K |
| A7038 |
Pos airway pressure filter |
783 |
746 |
$3K |
| A7037 |
Pos airway pressure tubing |
199 |
195 |
$2K |
| A4253 |
Blood glucose/reagent strips |
532 |
511 |
$2K |
| A7039 |
Filter, non disposable w pap |
121 |
117 |
$557.08 |
| A7031 |
Replacement facemask interfa |
13 |
12 |
$380.86 |
| A7004 |
Disposable nebulizer sml vol |
119 |
119 |
$255.04 |
| 0013A |
|
15 |
15 |
$0.00 |
| 0003A |
|
14 |
14 |
$0.00 |
| G0008 |
Admin influenza virus vac |
29 |
28 |
$0.00 |