| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,201 |
3,189 |
$370K |
| A4554 |
Disposable underpads, all sizes |
9,855 |
9,775 |
$351K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,806 |
1,779 |
$274K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
7,227 |
6,661 |
$264K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,982 |
1,977 |
$215K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,510 |
2,493 |
$141K |
| A4335 |
Incontinence supply; miscellaneous |
14,912 |
14,667 |
$82K |
| E1399 |
Durable medical equipment, miscellaneous |
43 |
40 |
$31K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
807 |
807 |
$20K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
853 |
809 |
$18K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,280 |
1,264 |
$16K |
| K0002 |
Standard hemi (low seat) wheelchair |
259 |
257 |
$9K |
| E0601 |
Continuous positive airway pressure (cpap) device |
89 |
87 |
$4K |
| A4259 |
Lancets, per box of 100 |
834 |
804 |
$3K |
| E0570 |
Nebulizer, with compressor |
678 |
678 |
$2K |
| K0001 |
Standard wheelchair |
274 |
274 |
$2K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12 |
12 |
$2K |
| 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 |
533 |
531 |
$1K |