| 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 |
9,119 |
8,118 |
$772K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,247 |
1,106 |
$124K |
| E0570 |
Nebulizer, with compressor |
1,553 |
1,393 |
$92K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,088 |
3,677 |
$75K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
355 |
305 |
$38K |
| E0601 |
Continuous positive airway pressure (cpap) device |
348 |
305 |
$17K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
442 |
413 |
$10K |
| 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 |
499 |
461 |
$9K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
45 |
38 |
$7K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
218 |
196 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
74 |
61 |
$4K |
| K0001 |
Standard wheelchair |
184 |
158 |
$3K |
| E1392 |
Portable oxygen concentrator, rental |
1,135 |
925 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
98 |
88 |
$3K |
| 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) |
41 |
37 |
$2K |
| A4554 |
Disposable underpads, all sizes |
86 |
85 |
$2K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
57 |
53 |
$2K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
18 |
12 |
$1K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
35 |
27 |
$740.38 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
116 |
99 |
$621.71 |
| A7035 |
Headgear used with positive airway pressure device |
14 |
13 |
$271.65 |
| A7037 |
Tubing used with positive airway pressure device |
69 |
60 |
$198.99 |
| A4927 |
Gloves, non-sterile, per 100 |
12 |
12 |
$117.52 |