| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,776 |
1,677 |
$131K |
| E0601 |
Cont airway pressure device |
1,078 |
981 |
$41K |
| A4335 |
Incontinence supply |
646 |
586 |
$33K |
| T4535 |
Disposable liner/shield/pad |
360 |
327 |
$26K |
| T2028 |
Special supply, nos waiver |
286 |
260 |
$25K |
| A7030 |
Cpap full face mask |
282 |
266 |
$20K |
| A7031 |
Replacement facemask interfa |
325 |
310 |
$19K |
| A7038 |
Pos airway pressure filter |
660 |
613 |
$8K |
| T4528 |
Adult size pull-on xl |
82 |
74 |
$8K |
| E0562 |
Humidifier heated used w pap |
350 |
302 |
$7K |
| E0570 |
Nebulizer with compression |
180 |
171 |
$7K |
| E0431 |
Portable gaseous 02 |
594 |
563 |
$6K |
| A7035 |
Pos airway press headgear |
180 |
164 |
$3K |
| A4604 |
Tubing with heating element |
65 |
57 |
$2K |
| A7037 |
Pos airway pressure tubing |
159 |
150 |
$2K |
| T4526 |
Adult size pull-on med |
12 |
12 |
$649.22 |
| A7046 |
Repl water chamber, pap dev |
38 |
37 |
$309.73 |
| A7003 |
Nebulizer administration set |
12 |
12 |
$28.16 |