| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
4,477 |
4,473 |
$316K |
| E0562 |
Humidifier heated used w pap |
4,405 |
4,402 |
$76K |
| A7030 |
Cpap full face mask |
661 |
660 |
$65K |
| E0470 |
Rad w/o backup non-inv intfc |
429 |
429 |
$59K |
| T4535 |
Disposable liner/shield/pad |
723 |
708 |
$38K |
| T4528 |
Adult size pull-on xl |
249 |
247 |
$32K |
| A7035 |
Pos airway press headgear |
971 |
971 |
$21K |
| T4526 |
Adult size pull-on med |
185 |
181 |
$20K |
| T1999 |
Noc retail items andsupplies |
100 |
99 |
$17K |
| T4541 |
Large disposable underpad |
390 |
387 |
$16K |
| T4527 |
Adult size pull-on lg |
151 |
149 |
$16K |
| A7037 |
Pos airway pressure tubing |
746 |
746 |
$13K |
| A7034 |
Nasal application device |
81 |
81 |
$6K |
| A7038 |
Pos airway pressure filter |
1,244 |
1,241 |
$6K |
| T4542 |
Small disposable underpad |
82 |
81 |
$4K |
| A7046 |
Repl water chamber, pap dev |
243 |
243 |
$3K |
| A7031 |
Replacement facemask interfa |
134 |
133 |
$2K |
| A4604 |
Tubing with heating element |
14 |
14 |
$487.43 |
| A7039 |
Filter, non disposable w pap |
109 |
109 |
$389.12 |
| A7032 |
Replacement nasal cushion |
12 |
12 |
$333.48 |