| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
982 |
919 |
$89K |
| T1999 |
Noc retail items andsupplies |
1,718 |
1,491 |
$70K |
| E0601 |
Cont airway pressure device |
399 |
369 |
$53K |
| T4527 |
Adult size pull-on lg |
400 |
362 |
$53K |
| T4535 |
Disposable liner/shield/pad |
938 |
806 |
$49K |
| T4537 |
Reusable underpad bed size |
840 |
751 |
$38K |
| T4541 |
Large disposable underpad |
819 |
698 |
$33K |
| T4526 |
Adult size pull-on med |
329 |
294 |
$32K |
| B4152 |
Ef calorie dense>/=1.5kcal |
220 |
142 |
$21K |
| T4528 |
Adult size pull-on xl |
186 |
162 |
$20K |
| A4927 |
Non-sterile gloves |
985 |
852 |
$19K |
| A7030 |
Cpap full face mask |
157 |
141 |
$18K |
| A7034 |
Nasal application device |
197 |
180 |
$15K |
| A7035 |
Pos airway press headgear |
460 |
421 |
$12K |
| A6530 |
Compression stocking bk18-30 |
101 |
87 |
$7K |
| E0562 |
Humidifier heated used w pap |
52 |
40 |
$6K |
| E1392 |
Portable oxygen concentrator |
483 |
440 |
$6K |
| A4604 |
Tubing with heating element |
109 |
104 |
$5K |
| E0570 |
Nebulizer with compression |
173 |
163 |
$4K |
| A7038 |
Pos airway pressure filter |
1,326 |
361 |
$4K |
| A9999 |
Dme supply or accessory, nos |
57 |
42 |
$2K |
| A7037 |
Pos airway pressure tubing |
30 |
24 |
$475.86 |