| 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 |
1,967 |
1,835 |
$166K |
| E1392 |
Portable oxygen concentrator, rental |
1,078 |
1,006 |
$30K |
| E0601 |
Continuous positive airway pressure (cpap) device |
446 |
424 |
$23K |
| A7030 |
Full face mask used with positive airway pressure device, each |
150 |
137 |
$21K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
488 |
469 |
$16K |
| E0570 |
Nebulizer, with compressor |
379 |
373 |
$15K |
| A7031 |
Face mask interface, replacement for full face mask, each |
253 |
237 |
$13K |
| A7037 |
Tubing used with positive airway pressure device |
215 |
203 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
772 |
738 |
$6K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
66 |
65 |
$6K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
56 |
55 |
$5K |
| A7035 |
Headgear used with positive airway pressure device |
174 |
169 |
$5K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
217 |
214 |
$4K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
28 |
28 |
$4K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
114 |
110 |
$3K |
| T4541 |
Incontinence product, disposable underpad, large, each |
34 |
34 |
$3K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
87 |
87 |
$2K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
16 |
16 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
79 |
69 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
119 |
110 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
41 |
41 |
$901.83 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
21 |
21 |
$523.82 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
13 |
13 |
$465.86 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
98 |
92 |
$349.93 |
| E0605 |
Vaporizer, room type |
13 |
13 |
$337.98 |
| A7015 |
Aerosol mask, used with dme nebulizer |
214 |
200 |
$258.31 |
| V5266 |
Battery for use in hearing device |
25 |
25 |
$212.55 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
188 |
181 |
$161.03 |