| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
3,079 |
3,010 |
$157K |
| A4604 |
Tubing with heating element |
1,175 |
1,144 |
$58K |
| A7031 |
Replacement facemask interfa |
1,298 |
1,272 |
$56K |
| A7030 |
Cpap full face mask |
362 |
356 |
$43K |
| T4535 |
Disposable liner/shield/pad |
542 |
539 |
$41K |
| A7035 |
Pos airway press headgear |
1,542 |
1,500 |
$39K |
| A7032 |
Replacement nasal cushion |
1,005 |
973 |
$37K |
| E1390 |
Oxygen concentrator |
404 |
400 |
$33K |
| A7038 |
Pos airway pressure filter |
5,622 |
5,385 |
$32K |
| T2029 |
Special med equip, noswaiver |
53 |
53 |
$30K |
| A7034 |
Nasal application device |
330 |
322 |
$25K |
| A7046 |
Repl water chamber, pap dev |
1,237 |
1,199 |
$16K |
| T4528 |
Adult size pull-on xl |
117 |
106 |
$13K |
| K0001 |
Standard wheelchair |
291 |
279 |
$9K |
| T4527 |
Adult size pull-on lg |
77 |
63 |
$5K |
| E0431 |
Portable gaseous 02 |
206 |
200 |
$5K |
| E0562 |
Humidifier heated used w pap |
38 |
38 |
$4K |
| E0443 |
Portable 02 contents, gas |
25 |
25 |
$1K |
| E0118 |
Crutch substitute |
13 |
12 |
$687.26 |
| A7039 |
Filter, non disposable w pap |
36 |
36 |
$428.28 |
| E0570 |
Nebulizer with compression |
53 |
53 |
$187.64 |