| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult size pull-on lg |
1,741 |
1,622 |
$242K |
| A4554 |
Disposable underpads |
3,923 |
3,578 |
$220K |
| T4528 |
Adult size pull-on xl |
1,282 |
1,172 |
$180K |
| T4526 |
Adult size pull-on med |
1,473 |
1,333 |
$169K |
| E1390 |
Oxygen concentrator |
2,145 |
1,413 |
$137K |
| E0601 |
Cont airway pressure device |
3,480 |
2,370 |
$122K |
| A7030 |
Cpap full face mask |
1,536 |
1,042 |
$84K |
| B4150 |
Ef complet w/intact nutrient |
1,040 |
657 |
$69K |
| E0570 |
Nebulizer with compression |
1,875 |
1,052 |
$28K |
| A7037 |
Pos airway pressure tubing |
2,388 |
1,626 |
$26K |
| A4927 |
Non-sterile gloves |
981 |
901 |
$19K |
| A7035 |
Pos airway press headgear |
1,323 |
930 |
$17K |
| K0738 |
Portable gas oxygen system |
908 |
600 |
$15K |
| A7038 |
Pos airway pressure filter |
3,065 |
2,114 |
$8K |
| B4154 |
Ef spec metabolic noninherit |
41 |
39 |
$6K |
| T4535 |
Disposable liner/shield/pad |
222 |
169 |
$6K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
24 |
24 |
$3K |
| K0001 |
Standard wheelchair |
256 |
146 |
$3K |
| E0562 |
Humidifier heated used w pap |
16 |
13 |
$2K |
| A7034 |
Nasal application device |
78 |
53 |
$2K |
| A4335 |
Incontinence supply |
267 |
260 |
$2K |
| A7031 |
Replacement facemask interfa |
74 |
50 |
$1K |
| A7003 |
Nebulizer administration set |
49 |
37 |
$89.38 |
| A7015 |
Aerosol mask used w nebulize |
55 |
36 |
$54.92 |
| A7046 |
Repl water chamber, pap dev |
19 |
12 |
$26.57 |