| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
2,165 |
1,988 |
$236K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,763 |
1,411 |
$75K |
| E0570 |
Nebulizer, with compressor |
983 |
777 |
$12K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
755 |
613 |
$9K |
| A4554 |
Disposable underpads, all sizes |
145 |
130 |
$4K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
690 |
625 |
$4K |
| K0001 |
Standard wheelchair |
243 |
202 |
$3K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
23 |
14 |
$154.49 |
| 0003A |
|
62 |
62 |
$0.00 |
| 0004A |
|
14 |
14 |
$0.00 |
| 0124A |
|
18 |
18 |
$0.00 |
| 91322 |
|
15 |
15 |
$0.00 |
| 0002A |
|
55 |
55 |
$0.00 |
| 91320 |
|
14 |
12 |
$0.00 |
| 90480 |
|
47 |
44 |
$0.00 |
| 0012A |
|
12 |
12 |
$0.00 |
| 90677 |
|
14 |
14 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
14 |
14 |
$0.00 |
| 0001A |
|
38 |
38 |
$0.00 |