| 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 |
2,412 |
2,410 |
$153K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,210 |
2,158 |
$100K |
| E0570 |
Nebulizer, with compressor |
1,536 |
1,536 |
$92K |
| A4335 |
Incontinence supply; miscellaneous |
1,319 |
1,279 |
$51K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
294 |
287 |
$47K |
| K0001 |
Standard wheelchair |
1,503 |
1,503 |
$38K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
470 |
462 |
$26K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,936 |
1,935 |
$25K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
914 |
900 |
$21K |
| A4927 |
Gloves, non-sterile, per 100 |
512 |
477 |
$19K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
521 |
519 |
$18K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
701 |
692 |
$18K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
91 |
91 |
$13K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
52 |
50 |
$6K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
898 |
898 |
$4K |