| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,811 |
3,790 |
$588K |
| A4554 |
Disposable underpads, all sizes |
15,274 |
15,099 |
$567K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,423 |
2,403 |
$463K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,741 |
2,714 |
$358K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,868 |
4,833 |
$240K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,330 |
2,238 |
$149K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
563 |
563 |
$148K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,027 |
974 |
$102K |
| E0570 |
Nebulizer, with compressor |
2,468 |
2,403 |
$97K |
| A4335 |
Incontinence supply; miscellaneous |
15,753 |
15,401 |
$88K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,355 |
2,123 |
$42K |
| K0001 |
Standard wheelchair |
1,952 |
1,897 |
$31K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,897 |
1,840 |
$22K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
740 |
726 |
$20K |
| E1399 |
Durable medical equipment, miscellaneous |
150 |
116 |
$16K |
| A4259 |
Lancets, per box of 100 |
2,036 |
1,944 |
$8K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,740 |
3,614 |
$5K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
36 |
36 |
$4K |
| A7015 |
Aerosol mask, used with dme nebulizer |
3,735 |
3,607 |
$3K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
3,767 |
3,649 |
$2K |
| A4670 |
Automatic blood pressure monitor |
12 |
12 |
$728.92 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
82 |
80 |
$635.16 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
56 |
48 |
$565.42 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
169 |
168 |
$424.02 |
| A7037 |
Tubing used with positive airway pressure device |
12 |
12 |
$167.06 |
| E0156 |
Seat attachment, walker |
146 |
145 |
$138.49 |
| A4322 |
Irrigation syringe, bulb or piston, each |
13 |
12 |
$93.56 |
| A4256 |
Normal, low and high calibrator solution / chips |
25 |
24 |
$39.94 |
| A4233 |
Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each |
18 |
13 |
$5.73 |