| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
3,079 |
3,010 |
$157K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,175 |
1,144 |
$58K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,298 |
1,272 |
$56K |
| A7030 |
Full face mask used with positive airway pressure device, each |
362 |
356 |
$43K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
542 |
539 |
$41K |
| A7035 |
Headgear used with positive airway pressure device |
1,542 |
1,500 |
$39K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,005 |
973 |
$37K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
404 |
400 |
$33K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,622 |
5,385 |
$32K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
53 |
53 |
$30K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
330 |
322 |
$25K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,237 |
1,199 |
$16K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
117 |
106 |
$13K |
| K0001 |
Standard wheelchair |
291 |
279 |
$9K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
77 |
63 |
$5K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
206 |
200 |
$5K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
38 |
38 |
$4K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
25 |
25 |
$1K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
13 |
12 |
$687.26 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
36 |
36 |
$428.28 |
| E0570 |
Nebulizer, with compressor |
53 |
53 |
$187.64 |