| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
336 |
325 |
$37K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,034 |
1,008 |
$34K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
201 |
195 |
$31K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
272 |
266 |
$26K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
454 |
448 |
$21K |
| T4541 |
Incontinence product, disposable underpad, large, each |
826 |
807 |
$18K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
108 |
108 |
$3K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
400 |
399 |
$2K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
13 |
13 |
$1K |
| E0570 |
Nebulizer, with compressor |
430 |
424 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
42 |
37 |
$574.01 |
| K0001 |
Standard wheelchair |
86 |
86 |
$447.14 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
227 |
215 |
$433.78 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
24 |
24 |
$364.54 |
| A7035 |
Headgear used with positive airway pressure device |
16 |
15 |
$40.82 |