| 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 |
4,987 |
4,525 |
$301K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
2,177 |
1,925 |
$207K |
| E0570 |
Nebulizer, with compressor |
2,463 |
2,303 |
$60K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,145 |
2,877 |
$42K |
| A4554 |
Disposable underpads, all sizes |
607 |
535 |
$12K |
| K0001 |
Standard wheelchair |
603 |
547 |
$8K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
247 |
229 |
$5K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
57 |
50 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
100 |
84 |
$679.41 |
| A7037 |
Tubing used with positive airway pressure device |
12 |
12 |
$389.01 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
483 |
227 |
$387.67 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
12 |
12 |
$373.33 |
| A4259 |
Lancets, per box of 100 |
76 |
58 |
$368.82 |