| 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 |
650 |
647 |
$67K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
269 |
269 |
$4K |
| T4541 |
Incontinence product, disposable underpad, large, each |
53 |
53 |
$2K |
| E0601 |
Continuous positive airway pressure (cpap) device |
12 |
12 |
$870.86 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
12 |
12 |
$725.70 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
24 |
24 |
$485.94 |