| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
445 |
441 |
$15K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
77 |
77 |
$13K |
| A4335 |
Incontinence supply; miscellaneous |
941 |
927 |
$5K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
29 |
28 |
$4K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
25 |
25 |
$2K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
29 |
29 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
13 |
12 |
$163.08 |
| E0570 |
Nebulizer, with compressor |
24 |
24 |
$26.76 |