| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult size pull-on xl |
653 |
567 |
$68K |
| T4527 |
Adult size pull-on lg |
702 |
667 |
$55K |
| E0601 |
Cont airway pressure device |
1,056 |
796 |
$55K |
| T4526 |
Adult size pull-on med |
398 |
369 |
$29K |
| T4535 |
Disposable liner/shield/pad |
782 |
715 |
$21K |
| E0570 |
Nebulizer with compression |
453 |
353 |
$21K |
| A4554 |
Disposable underpads |
671 |
597 |
$15K |
| A7030 |
Cpap full face mask |
204 |
164 |
$13K |
| A6549 |
Grad com garm noc day use |
27 |
12 |
$8K |
| A7035 |
Pos airway press headgear |
478 |
376 |
$6K |
| A7031 |
Replacement facemask interfa |
232 |
172 |
$5K |
| S5170 |
Homedelivered prepared meal |
55 |
52 |
$5K |
| A7038 |
Pos airway pressure filter |
1,170 |
949 |
$5K |
| A7034 |
Nasal application device |
142 |
109 |
$4K |
| A4927 |
Non-sterile gloves |
638 |
495 |
$3K |
| A4520 |
Incontinence garment anytype |
171 |
110 |
$3K |
| A4357 |
Bedside drainage bag |
760 |
563 |
$3K |
| A7039 |
Filter, non disposable w pap |
474 |
367 |
$2K |
| A7037 |
Pos airway pressure tubing |
782 |
624 |
$2K |
| A4385 |
Ost skn barrier sld ext wear |
58 |
38 |
$1K |
| E1390 |
Oxygen concentrator |
15 |
12 |
$1K |
| A4351 |
Straight tip urine catheter |
17 |
12 |
$984.76 |
| T4534 |
Youth size pull-on |
15 |
12 |
$820.00 |
| A7046 |
Repl water chamber, pap dev |
63 |
50 |
$353.83 |
| A7003 |
Nebulizer administration set |
112 |
87 |
$285.78 |
| A4358 |
Urinary leg or abdomen bag |
56 |
37 |
$47.51 |