| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
558 |
495 |
$141K |
| E1390 |
Oxygen concentrator |
1,308 |
1,247 |
$101K |
| E0601 |
Cont airway pressure device |
1,725 |
1,633 |
$70K |
| A7031 |
Replacement facemask interfa |
1,056 |
1,033 |
$47K |
| A4604 |
Tubing with heating element |
1,112 |
1,090 |
$46K |
| A7030 |
Cpap full face mask |
426 |
420 |
$43K |
| T4528 |
Adult size pull-on xl |
460 |
386 |
$40K |
| T4527 |
Adult size pull-on lg |
657 |
580 |
$38K |
| T4535 |
Disposable liner/shield/pad |
647 |
556 |
$36K |
| A7034 |
Nasal application device |
576 |
561 |
$36K |
| T4526 |
Adult size pull-on med |
488 |
421 |
$35K |
| A7032 |
Replacement nasal cushion |
719 |
701 |
$31K |
| A7035 |
Pos airway press headgear |
1,343 |
1,301 |
$28K |
| E0260 |
Hosp bed semi-electr w/ matt |
589 |
543 |
$28K |
| E1392 |
Portable oxygen concentrator |
754 |
720 |
$24K |
| E0570 |
Nebulizer with compression |
482 |
474 |
$19K |
| A7038 |
Pos airway pressure filter |
2,701 |
2,657 |
$15K |
| K0001 |
Standard wheelchair |
663 |
620 |
$14K |
| A7033 |
Replacement nasal pillows |
352 |
344 |
$12K |
| A7046 |
Repl water chamber, pap dev |
465 |
460 |
$6K |
| E0603 |
Electric breast pump |
27 |
25 |
$6K |
| E0562 |
Humidifier heated used w pap |
31 |
30 |
$5K |
| E0114 |
Crutch underarm pair no wood |
37 |
36 |
$2K |
| A7005 |
Nondisposable nebulizer set |
79 |
73 |
$1K |
| E0118 |
Crutch substitute |
12 |
12 |
$764.86 |