| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
1,385 |
993 |
$94K |
| E1390 |
Oxygen concentrator |
1,191 |
837 |
$52K |
| A4604 |
Tubing with heating element |
1,434 |
1,055 |
$43K |
| T4541 |
Large disposable underpad |
1,310 |
1,305 |
$40K |
| T4528 |
Adult size pull-on xl |
411 |
409 |
$40K |
| A4927 |
Non-sterile gloves |
2,432 |
2,411 |
$36K |
| E0570 |
Nebulizer with compression |
2,242 |
1,334 |
$30K |
| A7035 |
Pos airway press headgear |
1,089 |
848 |
$23K |
| T4526 |
Adult size pull-on med |
241 |
238 |
$19K |
| T4535 |
Disposable liner/shield/pad |
405 |
405 |
$16K |
| A7038 |
Pos airway pressure filter |
2,227 |
1,739 |
$14K |
| A7034 |
Nasal application device |
197 |
157 |
$13K |
| T4527 |
Adult size pull-on lg |
116 |
115 |
$10K |
| A7046 |
Repl water chamber, pap dev |
426 |
327 |
$4K |
| E0562 |
Humidifier heated used w pap |
39 |
25 |
$3K |
| E0431 |
Portable gaseous 02 |
383 |
266 |
$3K |
| A4253 |
Blood glucose/reagent strips |
583 |
547 |
$3K |
| A7030 |
Cpap full face mask |
34 |
24 |
$3K |
| 91320 |
|
20 |
20 |
$2K |
| 0013A |
|
68 |
68 |
$2K |
| 91322 |
|
14 |
14 |
$2K |
| 90480 |
|
40 |
40 |
$1K |
| T4537 |
Reusable underpad bed size |
36 |
36 |
$1K |
| A7031 |
Replacement facemask interfa |
59 |
36 |
$1K |
| A7003 |
Nebulizer administration set |
653 |
501 |
$1K |
| 90686 |
|
57 |
57 |
$1K |
| 0134A |
|
13 |
13 |
$516.00 |
| 90471 |
|
36 |
36 |
$381.64 |
| A7013 |
Disposable compressor filter |
563 |
432 |
$338.58 |
| 90656 |
|
13 |
13 |
$241.17 |
| A6402 |
Sterile gauze <= 16 sq in |
15 |
13 |
$206.51 |