| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
7,309 |
4,144 |
$1.35M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,206 |
4,189 |
$735K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,705 |
4,696 |
$555K |
| A4554 |
Disposable underpads, all sizes |
13,220 |
13,093 |
$482K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,002 |
2,996 |
$347K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
7,479 |
7,314 |
$305K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,012 |
1,993 |
$103K |
| A4335 |
Incontinence supply; miscellaneous |
19,554 |
19,206 |
$100K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,383 |
1,370 |
$68K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
551 |
501 |
$54K |
| K0003 |
Lightweight wheelchair |
1,370 |
1,359 |
$52K |
| E0601 |
Continuous positive airway pressure (cpap) device |
626 |
624 |
$31K |
| E0570 |
Nebulizer, with compressor |
986 |
983 |
$26K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
838 |
832 |
$14K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
647 |
620 |
$14K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
2,375 |
2,324 |
$13K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
115 |
101 |
$10K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
619 |
610 |
$10K |
| A7031 |
Face mask interface, replacement for full face mask, each |
255 |
255 |
$9K |
| B9998 |
Noc for enteral supplies |
152 |
121 |
$8K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
528 |
519 |
$6K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
24 |
24 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
847 |
847 |
$4K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
36 |
36 |
$4K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
37 |
36 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
276 |
276 |
$3K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
14 |
12 |
$3K |
| A4259 |
Lancets, per box of 100 |
407 |
401 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
39 |
39 |
$2K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
13 |
13 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
13 |
13 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
782 |
776 |
$864.03 |
| E1392 |
Portable oxygen concentrator, rental |
547 |
537 |
$834.86 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
12 |
12 |
$201.53 |