| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,970 |
3,563 |
$313K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,122 |
1,998 |
$200K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,381 |
1,323 |
$138K |
| A4927 |
Gloves, non-sterile, per 100 |
4,711 |
4,508 |
$85K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,131 |
1,966 |
$67K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,219 |
1,064 |
$53K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
427 |
383 |
$48K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
402 |
381 |
$37K |
| A4259 |
Lancets, per box of 100 |
731 |
628 |
$7K |
| E0601 |
Continuous positive airway pressure (cpap) device |
209 |
196 |
$5K |
| E0570 |
Nebulizer, with compressor |
173 |
159 |
$3K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,426 |
1,344 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
13 |
12 |
$1K |
| K0001 |
Standard wheelchair |
37 |
37 |
$424.07 |
| A7031 |
Face mask interface, replacement for full face mask, each |
87 |
78 |
$339.20 |
| A7035 |
Headgear used with positive airway pressure device |
73 |
68 |
$308.46 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
96 |
88 |
$154.48 |
| A7037 |
Tubing used with positive airway pressure device |
58 |
52 |
$87.42 |