| 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 |
1,208 |
1,195 |
$50K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
264 |
260 |
$26K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
326 |
317 |
$16K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
85 |
85 |
$14K |
| E0601 |
Continuous positive airway pressure (cpap) device |
370 |
360 |
$6K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
556 |
555 |
$5K |
| T4541 |
Incontinence product, disposable underpad, large, each |
162 |
162 |
$4K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
201 |
182 |
$3K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
83 |
65 |
$2K |
| E0570 |
Nebulizer, with compressor |
480 |
474 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
608 |
546 |
$1K |
| A7031 |
Face mask interface, replacement for full face mask, each |
75 |
68 |
$1K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
12 |
12 |
$1K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
62 |
56 |
$880.96 |
| A7035 |
Headgear used with positive airway pressure device |
85 |
78 |
$644.30 |
| A7030 |
Full face mask used with positive airway pressure device, each |
30 |
27 |
$630.50 |
| K0001 |
Standard wheelchair |
58 |
57 |
$448.73 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
54 |
52 |
$247.40 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
15 |
12 |
$34.72 |