| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4927 |
Gloves, non-sterile, per 100 |
888 |
781 |
$23K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
848 |
741 |
$21K |
| E0601 |
Continuous positive airway pressure (cpap) device |
796 |
717 |
$18K |
| A7031 |
Face mask interface, replacement for full face mask, each |
571 |
541 |
$18K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
135 |
127 |
$18K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
289 |
277 |
$15K |
| T4541 |
Incontinence product, disposable underpad, large, each |
174 |
168 |
$12K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
89 |
75 |
$11K |
| A7030 |
Full face mask used with positive airway pressure device, each |
135 |
134 |
$8K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
196 |
175 |
$8K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,315 |
1,221 |
$7K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
34 |
26 |
$4K |
| A4335 |
Incontinence supply; miscellaneous |
815 |
730 |
$3K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
39 |
37 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
39 |
37 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
97 |
94 |
$1K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
13 |
12 |
$78.61 |