| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
5,979 |
5,166 |
$931K |
| E1390 |
Oxygen concentrator |
2,330 |
2,099 |
$172K |
| E0601 |
Cont airway pressure device |
1,553 |
1,453 |
$87K |
| T4527 |
Adult size pull-on lg |
580 |
411 |
$31K |
| E0562 |
Humidifier heated used w pap |
390 |
373 |
$18K |
| A5513 |
Multi den insert custom mold |
113 |
85 |
$16K |
| A7030 |
Cpap full face mask |
162 |
140 |
$14K |
| E0431 |
Portable gaseous 02 |
651 |
594 |
$14K |
| T4528 |
Adult size pull-on xl |
159 |
127 |
$13K |
| A5500 |
Diab shoe for density insert |
152 |
117 |
$10K |
| A5514 |
Mult den insert dir carv/cam |
39 |
32 |
$8K |
| A7031 |
Replacement facemask interfa |
143 |
129 |
$5K |
| T4534 |
Youth size pull-on |
40 |
38 |
$4K |
| A4604 |
Tubing with heating element |
152 |
135 |
$3K |
| A7038 |
Pos airway pressure filter |
493 |
444 |
$3K |
| E0570 |
Nebulizer with compression |
42 |
40 |
$3K |
| A7035 |
Pos airway press headgear |
123 |
108 |
$2K |
| A7046 |
Repl water chamber, pap dev |
64 |
53 |
$670.20 |
| A7003 |
Nebulizer administration set |
18 |
17 |
$55.71 |