| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
506 |
485 |
$55K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
569 |
540 |
$55K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
395 |
384 |
$53K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,344 |
1,196 |
$45K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
513 |
460 |
$32K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
845 |
793 |
$30K |
| A7030 |
Full face mask used with positive airway pressure device, each |
221 |
214 |
$22K |
| T4541 |
Incontinence product, disposable underpad, large, each |
628 |
591 |
$20K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
208 |
197 |
$18K |
| A7031 |
Face mask interface, replacement for full face mask, each |
280 |
253 |
$10K |
| E0570 |
Nebulizer, with compressor |
235 |
208 |
$9K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
106 |
91 |
$9K |
| A7035 |
Headgear used with positive airway pressure device |
355 |
338 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,628 |
1,509 |
$6K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
41 |
39 |
$2K |
| K0001 |
Standard wheelchair |
55 |
55 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
106 |
100 |
$1K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
12 |
12 |
$659.39 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
87 |
86 |
$225.22 |