| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4335 |
Incontinence supply |
1,611 |
1,598 |
$112K |
| A4452 |
Waterproof tape |
2,298 |
2,255 |
$81K |
| T4541 |
Large disposable underpad |
897 |
884 |
$51K |
| A6446 |
Conform band s w>=3" <5"/yd |
2,090 |
2,008 |
$48K |
| E1390 |
Oxygen concentrator |
397 |
390 |
$42K |
| T4535 |
Disposable liner/shield/pad |
417 |
414 |
$34K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
1,363 |
1,340 |
$28K |
| A6445 |
Conform band s w <3"/yd |
1,517 |
1,487 |
$26K |
| A4930 |
Sterile, gloves per pair |
174 |
166 |
$13K |
| E0570 |
Nebulizer with compression |
138 |
138 |
$13K |
| E0431 |
Portable gaseous 02 |
335 |
334 |
$7K |
| A6447 |
Conform band s w >=5"/yd |
137 |
137 |
$5K |
| A7005 |
Nondisposable nebulizer set |
117 |
117 |
$2K |
| A7002 |
Tubing used w suction pump |
236 |
224 |
$1K |
| A7000 |
Disposable canister for pump |
277 |
276 |
$1K |
| A6216 |
Non-sterile gauze<=16 sq in |
195 |
191 |
$1K |
| A7037 |
Pos airway pressure tubing |
68 |
63 |
$726.83 |
| A6402 |
Sterile gauze <= 16 sq in |
74 |
72 |
$702.89 |
| A6403 |
Sterile gauze>16 <= 48 sq in |
12 |
12 |
$467.73 |
| A7031 |
Replacement facemask interfa |
15 |
14 |
$390.29 |
| A7035 |
Pos airway press headgear |
26 |
25 |
$389.20 |
| A7038 |
Pos airway pressure filter |
98 |
93 |
$310.88 |
| A7015 |
Aerosol mask used w nebulize |
125 |
121 |
$245.04 |
| A7003 |
Nebulizer administration set |
12 |
12 |
$10.35 |