| 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 |
19,512 |
19,272 |
$1.07M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,200 |
2,189 |
$864K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
2,058 |
2,026 |
$653K |
| T4541 |
Incontinence product, disposable underpad, large, each |
4,833 |
4,798 |
$208K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,466 |
4,364 |
$191K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,376 |
2,358 |
$138K |
| 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) |
870 |
851 |
$123K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,642 |
7,529 |
$93K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
7,357 |
7,274 |
$93K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,385 |
1,373 |
$92K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,179 |
2,146 |
$92K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,450 |
1,439 |
$79K |
| K0001 |
Standard wheelchair |
3,560 |
3,456 |
$77K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,102 |
1,097 |
$57K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,133 |
2,118 |
$49K |
| E1392 |
Portable oxygen concentrator, rental |
2,281 |
2,260 |
$43K |
| E0570 |
Nebulizer, with compressor |
4,878 |
4,745 |
$35K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,434 |
1,417 |
$31K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
797 |
795 |
$25K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
701 |
693 |
$20K |
| S9999 |
Sales tax |
6,151 |
5,968 |
$19K |
| A7031 |
Face mask interface, replacement for full face mask, each |
717 |
714 |
$17K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,628 |
3,608 |
$12K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,158 |
1,147 |
$11K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
422 |
421 |
$10K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
177 |
177 |
$10K |
| A7035 |
Headgear used with positive airway pressure device |
1,036 |
1,033 |
$9K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
514 |
511 |
$5K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,715 |
1,711 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
423 |
421 |
$3K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
47 |
47 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
176 |
176 |
$797.83 |
| A7036 |
Chinstrap used with positive airway pressure device |
41 |
41 |
$337.38 |