| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
3,390 |
3,236 |
$111K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
772 |
749 |
$94K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,066 |
1,013 |
$79K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
437 |
402 |
$75K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,638 |
2,504 |
$71K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,013 |
966 |
$68K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
630 |
609 |
$66K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,252 |
1,085 |
$66K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,314 |
1,250 |
$54K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,342 |
2,241 |
$53K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,115 |
2,016 |
$44K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,098 |
1,045 |
$30K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
632 |
621 |
$26K |
| A7035 |
Headgear used with positive airway pressure device |
1,780 |
1,695 |
$24K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
289 |
273 |
$24K |
| A4927 |
Gloves, non-sterile, per 100 |
1,147 |
1,096 |
$22K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
900 |
869 |
$19K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,783 |
4,577 |
$16K |
| B9002 |
Enteral nutrition infusion pump, any type |
149 |
145 |
$12K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
467 |
431 |
$5K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
507 |
482 |
$4K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
27 |
24 |
$3K |
| E0776 |
Iv pole |
99 |
95 |
$2K |
| T4541 |
Incontinence product, disposable underpad, large, each |
12 |
12 |
$364.80 |