| 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 |
2,259 |
2,219 |
$227K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,099 |
2,041 |
$36K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
104 |
104 |
$11K |
| T4541 |
Incontinence product, disposable underpad, large, each |
202 |
192 |
$9K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
1,270 |
1,121 |
$8K |
| A7030 |
Full face mask used with positive airway pressure device, each |
67 |
65 |
$6K |
| K0001 |
Standard wheelchair |
167 |
167 |
$4K |
| A7031 |
Face mask interface, replacement for full face mask, each |
50 |
50 |
$3K |
| E0570 |
Nebulizer, with compressor |
24 |
24 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
109 |
109 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
150 |
145 |
$706.12 |
| A7035 |
Headgear used with positive airway pressure device |
13 |
13 |
$242.06 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
12 |
12 |
$12.36 |