| 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 |
2,689 |
1,566 |
$53K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
347 |
253 |
$40K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
209 |
166 |
$27K |
| K0001 |
Standard wheelchair |
2,186 |
1,347 |
$14K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
789 |
545 |
$12K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,076 |
550 |
$11K |
| E0570 |
Nebulizer, with compressor |
802 |
432 |
$8K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
751 |
428 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
257 |
171 |
$908.03 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
294 |
178 |
$847.83 |
| A4554 |
Disposable underpads, all sizes |
14 |
12 |
$797.61 |
| A7035 |
Headgear used with positive airway pressure device |
99 |
70 |
$711.84 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
273 |
124 |
$273.98 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
17 |
12 |
$194.21 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
38 |
25 |
$149.84 |
| A7031 |
Face mask interface, replacement for full face mask, each |
24 |
12 |
$128.48 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
123 |
72 |
$97.00 |