| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,641 |
1,527 |
$125K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,081 |
2,720 |
$118K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,367 |
2,116 |
$82K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
567 |
552 |
$69K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,870 |
1,626 |
$67K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,628 |
1,526 |
$66K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
345 |
327 |
$45K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,888 |
2,563 |
$44K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,444 |
1,283 |
$43K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
774 |
671 |
$42K |
| T4541 |
Incontinence product, disposable underpad, large, each |
897 |
858 |
$31K |
| A7035 |
Headgear used with positive airway pressure device |
1,673 |
1,472 |
$28K |
| A4927 |
Gloves, non-sterile, per 100 |
1,211 |
1,103 |
$26K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
203 |
192 |
$23K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
337 |
311 |
$23K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
245 |
211 |
$22K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
159 |
133 |
$19K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,811 |
4,232 |
$19K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
548 |
474 |
$15K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,052 |
917 |
$11K |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
86 |
81 |
$7K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
18 |
13 |
$6K |
| A7030 |
Full face mask used with positive airway pressure device, each |
71 |
62 |
$5K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
41 |
38 |
$4K |
| T2028 |
Specialized supply, not otherwise specified, waiver |
24 |
12 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
206 |
185 |
$1K |
| A7036 |
Chinstrap used with positive airway pressure device |
17 |
16 |
$204.18 |
| A4402 |
Lubricant, per ounce |
29 |
24 |
$136.00 |