| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,992 |
1,850 |
$206K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,014 |
3,503 |
$156K |
| T4541 |
Incontinence product, disposable underpad, large, each |
3,841 |
3,533 |
$134K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,858 |
1,735 |
$99K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,183 |
2,769 |
$49K |
| E0570 |
Nebulizer, with compressor |
1,617 |
1,453 |
$39K |
| K0001 |
Standard wheelchair |
1,632 |
1,482 |
$36K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
703 |
657 |
$28K |
| A4927 |
Gloves, non-sterile, per 100 |
1,140 |
1,043 |
$16K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
116 |
99 |
$10K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
55 |
49 |
$6K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
73 |
72 |
$4K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
204 |
198 |
$2K |
| A4670 |
Automatic blood pressure monitor |
49 |
49 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
13 |
13 |
$13.98 |