| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9977 |
Meals, per diem, not otherwise specified |
3,119 |
2,938 |
$448K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,090 |
3,647 |
$447K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,770 |
3,439 |
$312K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,509 |
2,216 |
$195K |
| A4335 |
Incontinence supply; miscellaneous |
6,629 |
5,945 |
$166K |
| T4541 |
Incontinence product, disposable underpad, large, each |
3,324 |
2,884 |
$98K |
| T2028 |
Specialized supply, not otherwise specified, waiver |
700 |
635 |
$86K |
| E1392 |
Portable oxygen concentrator, rental |
2,453 |
2,218 |
$62K |
| A4927 |
Gloves, non-sterile, per 100 |
2,745 |
2,455 |
$47K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
396 |
352 |
$42K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
169 |
161 |
$22K |
| K0001 |
Standard wheelchair |
853 |
660 |
$21K |
| E0570 |
Nebulizer, with compressor |
294 |
192 |
$18K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
122 |
108 |
$14K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
159 |
149 |
$10K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
295 |
195 |
$5K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
46 |
39 |
$4K |