| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
381 |
342 |
$48K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
358 |
336 |
$36K |
| E0601 |
Continuous positive airway pressure (cpap) device |
491 |
438 |
$35K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
496 |
438 |
$18K |
| A7030 |
Full face mask used with positive airway pressure device, each |
78 |
70 |
$9K |
| A7031 |
Face mask interface, replacement for full face mask, each |
194 |
186 |
$8K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
88 |
81 |
$8K |
| A4554 |
Disposable underpads, all sizes |
312 |
260 |
$7K |
| A7035 |
Headgear used with positive airway pressure device |
230 |
213 |
$5K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
158 |
143 |
$4K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
45 |
37 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
810 |
758 |
$3K |
| E0570 |
Nebulizer, with compressor |
112 |
96 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
286 |
265 |
$785.03 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
15 |
14 |
$557.32 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
43 |
36 |
$383.93 |
| A4927 |
Gloves, non-sterile, per 100 |
58 |
52 |
$233.00 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
18 |
12 |
$214.74 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
55 |
50 |
$165.43 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
14 |
13 |
$129.77 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
12 |
12 |
$41.28 |