| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
78 |
76 |
$9K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
67 |
67 |
$8K |
| E0601 |
Continuous positive airway pressure (cpap) device |
133 |
125 |
$4K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
173 |
162 |
$2K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
12 |
12 |
$2K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
73 |
65 |
$1K |
| E0570 |
Nebulizer, with compressor |
26 |
26 |
$510.95 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
27 |
26 |
$49.34 |
| 90686 |
|
29 |
29 |
$7.38 |
| 90662 |
|
15 |
15 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
124 |
120 |
$0.00 |
| 90688 |
|
40 |
39 |
$0.00 |