| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer, with compressor |
3,111 |
2,420 |
$192K |
| A4554 |
Disposable underpads, all sizes |
2,120 |
1,932 |
$124K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,249 |
1,151 |
$116K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
430 |
405 |
$44K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
708 |
624 |
$33K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
909 |
626 |
$29K |
| E0601 |
Continuous positive airway pressure (cpap) device |
606 |
457 |
$26K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
276 |
262 |
$24K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
849 |
741 |
$19K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
40 |
37 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
153 |
145 |
$4K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,401 |
2,027 |
$3K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
642 |
429 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,514 |
1,272 |
$3K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
57 |
52 |
$500.63 |
| L8000 |
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type |
48 |
27 |
$480.39 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
470 |
434 |
$203.89 |
| A7037 |
Tubing used with positive airway pressure device |
12 |
12 |
$176.56 |
| A7035 |
Headgear used with positive airway pressure device |
14 |
13 |
$159.20 |
| A4259 |
Lancets, per box of 100 |
362 |
329 |
$25.98 |