| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment anytype |
5,464 |
4,253 |
$522K |
| E0651 |
Pneum compressor segmental |
712 |
652 |
$46K |
| E1390 |
Oxygen concentrator |
627 |
566 |
$43K |
| A6549 |
Grad com garm noc day use |
562 |
115 |
$39K |
| A4554 |
Disposable underpads |
2,367 |
1,754 |
$37K |
| E0601 |
Cont airway pressure device |
646 |
562 |
$29K |
| A4351 |
Straight tip urine catheter |
291 |
183 |
$20K |
| E0570 |
Nebulizer with compression |
731 |
652 |
$13K |
| A7037 |
Pos airway pressure tubing |
412 |
368 |
$6K |
| E0260 |
Hosp bed semi-electr w/ matt |
127 |
113 |
$5K |
| A7035 |
Pos airway press headgear |
214 |
191 |
$3K |
| A7030 |
Cpap full face mask |
48 |
42 |
$3K |
| A7034 |
Nasal application device |
68 |
56 |
$3K |
| K0001 |
Standard wheelchair |
127 |
118 |
$1K |
| A5512 |
Multi den insert direct form |
26 |
12 |
$1K |
| A5500 |
Diab shoe for density insert |
24 |
12 |
$1K |
| A7039 |
Filter, non disposable w pap |
114 |
97 |
$634.58 |
| A7038 |
Pos airway pressure filter |
84 |
74 |
$258.12 |