| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
653 |
567 |
$68K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
702 |
667 |
$55K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,056 |
796 |
$55K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
398 |
369 |
$29K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
782 |
715 |
$21K |
| E0570 |
Nebulizer, with compressor |
453 |
353 |
$21K |
| A4554 |
Disposable underpads, all sizes |
671 |
597 |
$15K |
| A7030 |
Full face mask used with positive airway pressure device, each |
204 |
164 |
$13K |
| A6549 |
Gradient compression garment, not otherwise specified, for daytime use, each |
27 |
12 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
478 |
376 |
$6K |
| A7031 |
Face mask interface, replacement for full face mask, each |
232 |
172 |
$5K |
| S5170 |
Home delivered meals, including preparation; per meal |
55 |
52 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,170 |
949 |
$5K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
142 |
109 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
638 |
495 |
$3K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
171 |
110 |
$3K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
760 |
563 |
$3K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
474 |
367 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
782 |
624 |
$2K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
58 |
38 |
$1K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
15 |
12 |
$1K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
17 |
12 |
$984.76 |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
15 |
12 |
$820.00 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
63 |
50 |
$353.83 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
112 |
87 |
$285.78 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
56 |
37 |
$47.51 |