| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,124 |
1,057 |
$92K |
| S9977 |
Meals, per diem, not otherwise specified |
513 |
456 |
$74K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
546 |
497 |
$59K |
| T2028 |
Specialized supply, not otherwise specified, waiver |
403 |
359 |
$48K |
| A4335 |
Incontinence supply; miscellaneous |
1,954 |
1,867 |
$40K |
| T4541 |
Incontinence product, disposable underpad, large, each |
469 |
439 |
$18K |
| E0601 |
Continuous positive airway pressure (cpap) device |
542 |
497 |
$17K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
386 |
361 |
$10K |
| A4927 |
Gloves, non-sterile, per 100 |
652 |
613 |
$10K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
984 |
923 |
$10K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
41 |
37 |
$7K |
| A7031 |
Face mask interface, replacement for full face mask, each |
43 |
40 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
68 |
64 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
80 |
76 |
$638.00 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
17 |
15 |
$346.20 |