| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/pad |
1,641 |
1,527 |
$125K |
| E0601 |
Cont airway pressure device |
3,081 |
2,720 |
$118K |
| A4604 |
Tubing with heating element |
2,367 |
2,116 |
$82K |
| T4534 |
Youth size pull-on |
567 |
552 |
$69K |
| A7032 |
Replacement nasal cushion |
1,870 |
1,626 |
$67K |
| T4537 |
Reusable underpad bed size |
1,628 |
1,526 |
$66K |
| T4528 |
Adult size pull-on xl |
345 |
327 |
$45K |
| E0562 |
Humidifier heated used w pap |
2,888 |
2,563 |
$44K |
| A7031 |
Replacement facemask interfa |
1,444 |
1,283 |
$43K |
| A7034 |
Nasal application device |
774 |
671 |
$42K |
| T4541 |
Large disposable underpad |
897 |
858 |
$31K |
| A7035 |
Pos airway press headgear |
1,673 |
1,472 |
$28K |
| A4927 |
Non-sterile gloves |
1,211 |
1,103 |
$26K |
| T4527 |
Adult size pull-on lg |
203 |
192 |
$23K |
| A6530 |
Compression stocking bk18-30 |
337 |
311 |
$23K |
| T4526 |
Adult size pull-on med |
245 |
211 |
$22K |
| A4351 |
Straight tip urine catheter |
159 |
133 |
$19K |
| A7038 |
Pos airway pressure filter |
4,811 |
4,232 |
$19K |
| A7033 |
Replacement nasal pillows |
548 |
474 |
$15K |
| A7046 |
Repl water chamber, pap dev |
1,052 |
917 |
$11K |
| L0621 |
Sio flex pelvic/sacr pre ots |
86 |
81 |
$7K |
| T2029 |
Special med equip, noswaiver |
18 |
13 |
$6K |
| A7030 |
Cpap full face mask |
71 |
62 |
$5K |
| A6533 |
Gc stocking thighlngth 18-30 |
41 |
38 |
$4K |
| T2028 |
Special supply, nos waiver |
24 |
12 |
$1K |
| A7039 |
Filter, non disposable w pap |
206 |
185 |
$1K |
| A7036 |
Pos airway press chinstrap |
17 |
16 |
$204.18 |
| A4402 |
Lubricant per ounce |
29 |
24 |
$136.00 |