| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,565 |
1,394 |
$61K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
261 |
244 |
$15K |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
19 |
18 |
$12K |
| A4554 |
Disposable underpads, all sizes |
355 |
330 |
$11K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
96 |
92 |
$3K |
| A4259 |
Lancets, per box of 100 |
84 |
77 |
$1K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
12 |
12 |
$975.28 |
| E0570 |
Nebulizer, with compressor |
12 |
12 |
$396.08 |
| A4927 |
Gloves, non-sterile, per 100 |
13 |
12 |
$384.16 |