| 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 |
3,777 |
3,385 |
$233K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,340 |
2,121 |
$33K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,797 |
1,668 |
$21K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
101 |
89 |
$11K |
| E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
144 |
140 |
$3K |
| E0570 |
Nebulizer, with compressor |
112 |
93 |
$3K |
| A4259 |
Lancets, per box of 100 |
571 |
531 |
$2K |
| A4215 |
Needle, sterile, any size, each |
67 |
65 |
$2K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
32 |
28 |
$2K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
222 |
191 |
$1K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
141 |
139 |
$947.42 |
| A4245 |
Alcohol wipes, per box |
163 |
155 |
$789.00 |