| 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 |
2,285 |
2,284 |
$93K |
| E0570 |
Nebulizer, with compressor |
1,441 |
1,437 |
$60K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
817 |
807 |
$55K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
446 |
443 |
$45K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
326 |
326 |
$31K |
| K0001 |
Standard wheelchair |
848 |
848 |
$15K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,840 |
1,839 |
$13K |
| E0601 |
Continuous positive airway pressure (cpap) device |
357 |
357 |
$13K |
| T4541 |
Incontinence product, disposable underpad, large, each |
435 |
434 |
$12K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
909 |
908 |
$9K |
| A7030 |
Full face mask used with positive airway pressure device, each |
69 |
69 |
$7K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
136 |
135 |
$5K |
| 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) |
40 |
40 |
$3K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
30 |
30 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
103 |
103 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
352 |
350 |
$637.87 |
| A7037 |
Tubing used with positive airway pressure device |
13 |
13 |
$271.53 |