| 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 |
681 |
570 |
$37K |
| E0570 |
Nebulizer, with compressor |
1,263 |
1,102 |
$7K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
43 |
37 |
$5K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
306 |
254 |
$3K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
26 |
26 |
$2K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
15 |
12 |
$2K |