| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,333 |
1,263 |
$80K |
| A4335 |
Incontinence supply |
1,785 |
1,659 |
$76K |
| T4526 |
Adult size pull-on med |
563 |
525 |
$42K |
| T2028 |
Special supply, nos waiver |
347 |
325 |
$38K |
| E0601 |
Cont airway pressure device |
966 |
918 |
$35K |
| T4528 |
Adult size pull-on xl |
258 |
249 |
$29K |
| A7031 |
Replacement facemask interfa |
556 |
530 |
$25K |
| E0570 |
Nebulizer with compression |
503 |
486 |
$24K |
| A4604 |
Tubing with heating element |
657 |
628 |
$18K |
| B4035 |
Enteral feed supp pump per d |
61 |
49 |
$11K |
| E1392 |
Portable oxygen concentrator |
621 |
578 |
$10K |
| E0562 |
Humidifier heated used w pap |
846 |
785 |
$10K |
| A7030 |
Cpap full face mask |
121 |
117 |
$8K |
| T4527 |
Adult size pull-on lg |
90 |
79 |
$7K |
| T4535 |
Disposable liner/shield/pad |
132 |
129 |
$7K |
| A7038 |
Pos airway pressure filter |
1,164 |
1,092 |
$7K |
| A7035 |
Pos airway press headgear |
252 |
236 |
$4K |
| A7005 |
Nondisposable nebulizer set |
129 |
126 |
$3K |
| A4927 |
Non-sterile gloves |
34 |
30 |
$981.51 |
| A7034 |
Nasal application device |
17 |
16 |
$710.89 |
| A7046 |
Repl water chamber, pap dev |
39 |
37 |
$243.33 |