| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
506 |
485 |
$55K |
| T4526 |
Adult size pull-on med |
569 |
540 |
$55K |
| T4528 |
Adult size pull-on xl |
395 |
384 |
$53K |
| E0601 |
Cont airway pressure device |
1,344 |
1,196 |
$45K |
| T4535 |
Disposable liner/shield/pad |
513 |
460 |
$32K |
| A4604 |
Tubing with heating element |
845 |
793 |
$30K |
| A7030 |
Cpap full face mask |
221 |
214 |
$22K |
| T4541 |
Large disposable underpad |
628 |
591 |
$20K |
| E1390 |
Oxygen concentrator |
208 |
197 |
$18K |
| A7031 |
Replacement facemask interfa |
280 |
253 |
$10K |
| E0570 |
Nebulizer with compression |
235 |
208 |
$9K |
| T2029 |
Special med equip, noswaiver |
106 |
91 |
$9K |
| A7035 |
Pos airway press headgear |
355 |
338 |
$7K |
| A7038 |
Pos airway pressure filter |
1,628 |
1,509 |
$6K |
| A7034 |
Nasal application device |
41 |
39 |
$2K |
| K0001 |
Standard wheelchair |
55 |
55 |
$1K |
| A7046 |
Repl water chamber, pap dev |
106 |
100 |
$1K |
| E0114 |
Crutch underarm pair no wood |
12 |
12 |
$659.39 |
| A7003 |
Nebulizer administration set |
87 |
86 |
$225.22 |