| 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 |
1,782 |
1,448 |
$119K |
| A4554 |
Disposable underpads, all sizes |
2,325 |
2,137 |
$113K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,147 |
1,082 |
$83K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,876 |
1,161 |
$57K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
270 |
252 |
$26K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
158 |
155 |
$15K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
178 |
160 |
$15K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
71 |
71 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
115 |
94 |
$1K |
| A4259 |
Lancets, per box of 100 |
26 |
26 |
$420.00 |