| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
12,823 |
12,149 |
$682K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,618 |
4,362 |
$441K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,626 |
3,458 |
$429K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,626 |
4,442 |
$393K |
| T4541 |
Incontinence product, disposable underpad, large, each |
8,561 |
8,104 |
$324K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,336 |
4,321 |
$269K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
735 |
700 |
$141K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,310 |
1,304 |
$137K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
661 |
619 |
$136K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
502 |
489 |
$86K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,195 |
1,142 |
$79K |
| A4335 |
Incontinence supply; miscellaneous |
2,218 |
2,135 |
$49K |
| A4927 |
Gloves, non-sterile, per 100 |
1,813 |
1,762 |
$45K |
| E0601 |
Continuous positive airway pressure (cpap) device |
561 |
559 |
$30K |
| E0570 |
Nebulizer, with compressor |
1,061 |
1,056 |
$21K |
| E1392 |
Portable oxygen concentrator, rental |
1,467 |
1,465 |
$21K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
726 |
722 |
$18K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,502 |
1,491 |
$17K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
605 |
603 |
$14K |
| E1399 |
Durable medical equipment, miscellaneous |
130 |
126 |
$11K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
100 |
100 |
$11K |
| K0001 |
Standard wheelchair |
438 |
437 |
$11K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
55 |
49 |
$7K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
29 |
29 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
12 |
12 |
$1K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
141 |
128 |
$487.63 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
136 |
135 |
$464.56 |
| A7035 |
Headgear used with positive airway pressure device |
29 |
29 |
$378.66 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
40 |
40 |
$94.91 |