| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S8121 |
Oxygen contents, liquid, 1 unit equals 1 pound |
9,721 |
3,073 |
$2.77M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
19,558 |
8,898 |
$879K |
| E0442 |
Stationary oxygen contents, liquid, 1 month's supply = 1 unit |
18,253 |
7,039 |
$406K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
25,958 |
10,085 |
$358K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
786 |
647 |
$115K |
| A4554 |
Disposable underpads, all sizes |
1,735 |
1,569 |
$102K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,227 |
1,096 |
$95K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
314 |
275 |
$41K |
| A4927 |
Gloves, non-sterile, per 100 |
2,699 |
1,820 |
$40K |
| E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
546 |
171 |
$10K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
747 |
541 |
$9K |