| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,296 |
1,234 |
$107K |
| E0601 |
Cont airway pressure device |
1,309 |
1,157 |
$84K |
| E0562 |
Humidifier heated used w pap |
820 |
743 |
$23K |
| T4527 |
Adult size pull-on lg |
206 |
189 |
$20K |
| T4528 |
Adult size pull-on xl |
151 |
143 |
$19K |
| A7030 |
Cpap full face mask |
121 |
113 |
$12K |
| T4535 |
Disposable liner/shield/pad |
196 |
160 |
$6K |
| A7031 |
Replacement facemask interfa |
170 |
158 |
$5K |
| A4554 |
Disposable underpads |
202 |
180 |
$5K |
| E0431 |
Portable gaseous 02 |
354 |
350 |
$5K |
| T4526 |
Adult size pull-on med |
55 |
51 |
$5K |
| S5170 |
Homedelivered prepared meal |
65 |
54 |
$5K |
| A7035 |
Pos airway press headgear |
193 |
179 |
$4K |
| A7038 |
Pos airway pressure filter |
799 |
753 |
$3K |
| E0570 |
Nebulizer with compression |
47 |
45 |
$3K |
| A7034 |
Nasal application device |
29 |
26 |
$1K |
| A4927 |
Non-sterile gloves |
146 |
128 |
$714.31 |
| A7037 |
Pos airway pressure tubing |
267 |
249 |
$616.69 |
| A7039 |
Filter, non disposable w pap |
69 |
63 |
$499.76 |
| A4357 |
Bedside drainage bag |
102 |
82 |
$417.09 |
| A7046 |
Repl water chamber, pap dev |
34 |
33 |
$344.85 |
| A4358 |
Urinary leg or abdomen bag |
18 |
12 |
$31.64 |
| A4520 |
Incontinence garment anytype |
13 |
13 |
$0.00 |