| 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 |
363 |
290 |
$20K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
205 |
194 |
$16K |
| A4554 |
Disposable underpads, all sizes |
586 |
534 |
$14K |
| A4927 |
Gloves, non-sterile, per 100 |
293 |
262 |
$5K |
| A4335 |
Incontinence supply; miscellaneous |
169 |
146 |
$5K |
| E0601 |
Continuous positive airway pressure (cpap) device |
154 |
117 |
$4K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
26 |
25 |
$2K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
13 |
13 |
$1K |