| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
3,231 |
3,069 |
$124K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,295 |
1,247 |
$117K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,918 |
1,850 |
$114K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
980 |
920 |
$99K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
912 |
882 |
$68K |
| T4541 |
Incontinence product, disposable underpad, large, each |
3,070 |
2,943 |
$67K |
| A4927 |
Gloves, non-sterile, per 100 |
3,127 |
2,997 |
$48K |
| A4215 |
Needle, sterile, any size, each |
2,914 |
2,534 |
$42K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
508 |
481 |
$34K |
| S8490 |
Insulin syringes (100 syringes, any size) |
1,654 |
1,543 |
$26K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
242 |
231 |
$23K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
184 |
180 |
$22K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
137 |
136 |
$15K |
| A4259 |
Lancets, per box of 100 |
2,805 |
2,669 |
$13K |
| E0570 |
Nebulizer, with compressor |
458 |
423 |
$13K |
| E0601 |
Continuous positive airway pressure (cpap) device |
147 |
131 |
$8K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
74 |
73 |
$6K |
| A4245 |
Alcohol wipes, per box |
2,593 |
2,467 |
$6K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
298 |
278 |
$6K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
43 |
39 |
$6K |
| A4670 |
Automatic blood pressure monitor |
88 |
87 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
182 |
165 |
$2K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
13 |
13 |
$2K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
26 |
26 |
$2K |
| K0001 |
Standard wheelchair |
26 |
24 |
$2K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
37 |
37 |
$1K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
48 |
48 |
$883.27 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
28 |
26 |
$43.00 |