| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
6,005 |
5,779 |
$388K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,664 |
1,589 |
$224K |
| A4927 |
Gloves, non-sterile, per 100 |
5,338 |
5,119 |
$214K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,322 |
1,282 |
$214K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
742 |
710 |
$116K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
910 |
625 |
$63K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
110 |
106 |
$17K |
| E0601 |
Continuous positive airway pressure (cpap) device |
298 |
210 |
$12K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
467 |
330 |
$6K |
| E0570 |
Nebulizer, with compressor |
34 |
27 |
$2K |
| 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) |
17 |
12 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
12 |
12 |
$210.41 |