| 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 |
3,003 |
2,961 |
$281K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,206 |
1,194 |
$145K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,523 |
1,511 |
$115K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,069 |
1,054 |
$56K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,458 |
2,435 |
$51K |
| E0570 |
Nebulizer, with compressor |
2,388 |
2,356 |
$33K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
697 |
691 |
$33K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,033 |
1,993 |
$31K |
| K0001 |
Standard wheelchair |
1,102 |
1,082 |
$25K |
| 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) |
176 |
173 |
$22K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
336 |
333 |
$20K |
| A7035 |
Headgear used with positive airway pressure device |
876 |
867 |
$19K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
91 |
88 |
$16K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,820 |
1,801 |
$13K |
| A7037 |
Tubing used with positive airway pressure device |
225 |
221 |
$5K |
| T4541 |
Incontinence product, disposable underpad, large, each |
183 |
180 |
$5K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
237 |
234 |
$3K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
197 |
197 |
$2K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
14 |
12 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
24 |
24 |
$2K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
12 |
12 |
$504.00 |
| A4927 |
Gloves, non-sterile, per 100 |
13 |
13 |
$313.36 |