| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
714 |
669 |
$125K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
820 |
761 |
$98K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,098 |
1,887 |
$84K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,298 |
1,171 |
$81K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
657 |
581 |
$65K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
549 |
505 |
$62K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
501 |
436 |
$53K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,158 |
1,087 |
$47K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
316 |
309 |
$38K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
860 |
741 |
$36K |
| B4100 |
Food thickener, administered orally, per ounce |
466 |
404 |
$29K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
444 |
413 |
$10K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
357 |
307 |
$4K |
| A7031 |
Face mask interface, replacement for full face mask, each |
58 |
52 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
41 |
39 |
$1K |
| K0001 |
Standard wheelchair |
39 |
39 |
$875.94 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
195 |
172 |
$803.94 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
15 |
13 |
$751.43 |
| A7035 |
Headgear used with positive airway pressure device |
29 |
26 |
$519.06 |