| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,802 |
1,554 |
$250K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,424 |
1,214 |
$197K |
| A4554 |
Disposable underpads, all sizes |
3,873 |
3,260 |
$194K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,326 |
2,435 |
$154K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
918 |
818 |
$119K |
| E0570 |
Nebulizer, with compressor |
3,547 |
2,608 |
$51K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,119 |
2,315 |
$26K |
| E0601 |
Continuous positive airway pressure (cpap) device |
668 |
540 |
$25K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
664 |
455 |
$21K |
| K0001 |
Standard wheelchair |
1,341 |
915 |
$20K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
109 |
101 |
$15K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,692 |
1,224 |
$5K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
28 |
26 |
$3K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
12 |
12 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
44 |
39 |
$734.00 |
| A7037 |
Tubing used with positive airway pressure device |
31 |
27 |
$492.91 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
310 |
250 |
$424.03 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
13 |
12 |
$394.61 |
| A4259 |
Lancets, per box of 100 |
1,357 |
981 |
$332.88 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
43 |
26 |
$292.84 |