| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
2,150 |
1,915 |
$311K |
| T4526 |
Adult size pull-on med |
2,070 |
1,851 |
$276K |
| T4528 |
Adult size pull-on xl |
1,857 |
1,709 |
$260K |
| T4541 |
Large disposable underpad |
2,153 |
2,029 |
$157K |
| T4535 |
Disposable liner/shield/pad |
4,684 |
4,196 |
$122K |
| A4927 |
Non-sterile gloves |
3,346 |
3,088 |
$95K |
| B4150 |
Ef complet w/intact nutrient |
841 |
675 |
$68K |
| E1390 |
Oxygen concentrator |
1,828 |
1,730 |
$62K |
| A4604 |
Tubing with heating element |
1,661 |
1,559 |
$54K |
| A7030 |
Cpap full face mask |
994 |
935 |
$51K |
| E0601 |
Cont airway pressure device |
2,045 |
1,864 |
$44K |
| A7031 |
Replacement facemask interfa |
1,397 |
1,258 |
$37K |
| E0570 |
Nebulizer with compression |
499 |
496 |
$27K |
| A7032 |
Replacement nasal cushion |
522 |
478 |
$27K |
| B4152 |
Ef calorie dense>/=1.5kcal |
160 |
147 |
$21K |
| A7005 |
Nondisposable nebulizer set |
591 |
586 |
$20K |
| A7034 |
Nasal application device |
580 |
539 |
$19K |
| T4537 |
Reusable underpad bed size |
166 |
158 |
$12K |
| A7038 |
Pos airway pressure filter |
2,483 |
2,277 |
$9K |
| A4335 |
Incontinence supply |
2,673 |
2,453 |
$9K |
| A7035 |
Pos airway press headgear |
750 |
687 |
$8K |
| K0003 |
Lightweight wheelchair |
65 |
61 |
$6K |
| A7046 |
Repl water chamber, pap dev |
509 |
463 |
$4K |
| T4522 |
Adult size brief/diaper med |
26 |
25 |
$4K |
| E0431 |
Portable gaseous 02 |
515 |
490 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
227 |
226 |
$459.01 |
| A6250 |
Skin seal protect moisturizr |
91 |
61 |
$127.54 |