| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,680 |
3,676 |
$329K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,488 |
2,461 |
$267K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,551 |
4,537 |
$263K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,650 |
2,638 |
$207K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,216 |
2,212 |
$190K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,080 |
1,078 |
$173K |
| T4541 |
Incontinence product, disposable underpad, large, each |
6,538 |
6,518 |
$156K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,245 |
1,242 |
$154K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
3,745 |
3,739 |
$144K |
| E0570 |
Nebulizer, with compressor |
1,011 |
990 |
$91K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
651 |
649 |
$72K |
| A4927 |
Gloves, non-sterile, per 100 |
2,704 |
2,625 |
$59K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
453 |
451 |
$44K |
| K0001 |
Standard wheelchair |
1,009 |
1,003 |
$23K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,285 |
1,269 |
$23K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
226 |
226 |
$19K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
780 |
775 |
$16K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
85 |
53 |
$6K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
136 |
131 |
$5K |
| A7031 |
Face mask interface, replacement for full face mask, each |
108 |
106 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
598 |
595 |
$3K |
| E0601 |
Continuous positive airway pressure (cpap) device |
39 |
39 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
535 |
530 |
$2K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12 |
12 |
$990.93 |
| A7035 |
Headgear used with positive airway pressure device |
45 |
43 |
$772.37 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
539 |
531 |
$646.22 |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
32 |
32 |
$353.40 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
26 |
26 |
$236.64 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
12 |
12 |
$183.73 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
12 |
12 |
$103.57 |
| A7015 |
Aerosol mask, used with dme nebulizer |
45 |
44 |
$61.57 |