| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,525 |
1,464 |
$255K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,362 |
1,346 |
$210K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,820 |
1,787 |
$119K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,220 |
1,145 |
$99K |
| K0001 |
Standard wheelchair |
1,042 |
1,016 |
$23K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
648 |
631 |
$8K |
| E0570 |
Nebulizer, with compressor |
355 |
344 |
$8K |
| A4927 |
Gloves, non-sterile, per 100 |
408 |
401 |
$6K |
| E0601 |
Continuous positive airway pressure (cpap) device |
26 |
26 |
$1K |