| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,627 |
1,532 |
$80K |
| T4527 |
Adult size pull-on lg |
362 |
329 |
$40K |
| T4537 |
Reusable underpad bed size |
1,002 |
962 |
$29K |
| T4528 |
Adult size pull-on xl |
248 |
224 |
$25K |
| T4541 |
Large disposable underpad |
1,340 |
1,270 |
$24K |
| T4526 |
Adult size pull-on med |
202 |
167 |
$18K |
| E0601 |
Cont airway pressure device |
463 |
431 |
$18K |
| A7030 |
Cpap full face mask |
251 |
239 |
$16K |
| T4544 |
Adlt disp und/pull on abv xl |
81 |
75 |
$15K |
| A4927 |
Non-sterile gloves |
751 |
666 |
$11K |
| E0562 |
Humidifier heated used w pap |
814 |
772 |
$9K |
| E0431 |
Portable gaseous 02 |
1,002 |
937 |
$8K |
| A7031 |
Replacement facemask interfa |
142 |
124 |
$3K |
| E0570 |
Nebulizer with compression |
485 |
443 |
$3K |
| K0001 |
Standard wheelchair |
136 |
128 |
$3K |
| A4604 |
Tubing with heating element |
95 |
94 |
$2K |
| A7038 |
Pos airway pressure filter |
525 |
495 |
$2K |
| A7035 |
Pos airway press headgear |
98 |
90 |
$1K |