| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
4,730 |
4,590 |
$891K |
| A7030 |
Cpap full face mask |
2,598 |
2,577 |
$362K |
| E0562 |
Humidifier heated used w pap |
1,707 |
1,682 |
$328K |
| A7034 |
Nasal application device |
3,353 |
3,331 |
$292K |
| T4527 |
Adult size pull-on lg |
3,338 |
3,330 |
$290K |
| A4604 |
Tubing with heating element |
5,463 |
5,427 |
$271K |
| T4526 |
Adult size pull-on med |
2,730 |
2,718 |
$199K |
| A7035 |
Pos airway press headgear |
5,974 |
5,930 |
$176K |
| T4535 |
Disposable liner/shield/pad |
4,890 |
4,866 |
$175K |
| T4528 |
Adult size pull-on xl |
1,501 |
1,499 |
$138K |
| A7038 |
Pos airway pressure filter |
16,543 |
16,407 |
$134K |
| A4927 |
Non-sterile gloves |
9,694 |
9,488 |
$103K |
| T4537 |
Reusable underpad bed size |
2,255 |
2,252 |
$84K |
| E0471 |
Rad w/backup non inv intrfc |
161 |
161 |
$79K |
| T4534 |
Youth size pull-on |
911 |
896 |
$73K |
| A7031 |
Replacement facemask interfa |
1,426 |
1,414 |
$72K |
| T4541 |
Large disposable underpad |
3,099 |
3,093 |
$70K |
| A4351 |
Straight tip urine catheter |
417 |
415 |
$62K |
| T4522 |
Adult size brief/diaper med |
713 |
712 |
$57K |
| T4523 |
Adult size brief/diaper lg |
627 |
627 |
$51K |
| A7046 |
Repl water chamber, pap dev |
3,531 |
3,503 |
$51K |
| E0570 |
Nebulizer with compression |
532 |
529 |
$45K |
| A4335 |
Incontinence supply |
1,094 |
1,074 |
$37K |
| A7032 |
Replacement nasal cushion |
1,215 |
1,208 |
$35K |
| A7039 |
Filter, non disposable w pap |
2,525 |
2,500 |
$29K |
| S9999 |
Sales tax |
1,696 |
1,642 |
$25K |
| T4524 |
Adult size brief/diaper xl |
270 |
269 |
$24K |
| T4525 |
Adult size pull-on sm |
282 |
281 |
$20K |
| T4530 |
Ped size brief/diaper lg |
337 |
335 |
$20K |
| A7005 |
Nondisposable nebulizer set |
357 |
355 |
$9K |
| A4253 |
Blood glucose/reagent strips |
842 |
834 |
$7K |
| E0470 |
Rad w/o backup non-inv intfc |
12 |
12 |
$5K |
| A7033 |
Replacement nasal pillows |
188 |
188 |
$4K |
| A7037 |
Pos airway pressure tubing |
86 |
83 |
$2K |
| T4521 |
Adult size brief/diaper sm |
25 |
25 |
$1K |
| K0001 |
Standard wheelchair |
29 |
29 |
$1K |
| A7013 |
Disposable compressor filter |
359 |
348 |
$994.91 |
| A4357 |
Bedside drainage bag |
94 |
92 |
$757.29 |
| E0143 |
Walker folding wheeled w/o s |
13 |
13 |
$622.00 |
| A4402 |
Lubricant per ounce |
64 |
63 |
$600.90 |
| E0114 |
Crutch underarm pair no wood |
14 |
14 |
$542.74 |
| A7015 |
Aerosol mask used w nebulize |
302 |
302 |
$485.34 |
| A4259 |
Lancets per box |
566 |
561 |
$396.71 |
| A7003 |
Nebulizer administration set |
74 |
74 |
$86.97 |