| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
1,385 |
993 |
$94K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,191 |
837 |
$52K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,434 |
1,055 |
$43K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,310 |
1,305 |
$40K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
411 |
409 |
$40K |
| A4927 |
Gloves, non-sterile, per 100 |
2,432 |
2,411 |
$36K |
| E0570 |
Nebulizer, with compressor |
2,242 |
1,334 |
$30K |
| A7035 |
Headgear used with positive airway pressure device |
1,089 |
848 |
$23K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
241 |
238 |
$19K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
405 |
405 |
$16K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,227 |
1,739 |
$14K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
197 |
157 |
$13K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
116 |
115 |
$10K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
426 |
327 |
$4K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
39 |
25 |
$3K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
383 |
266 |
$3K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
583 |
547 |
$3K |
| A7030 |
Full face mask used with positive airway pressure device, each |
34 |
24 |
$3K |
| 91320 |
|
20 |
20 |
$2K |
| 0013A |
|
68 |
68 |
$2K |
| 91322 |
|
14 |
14 |
$2K |
| 90480 |
|
40 |
40 |
$1K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
36 |
36 |
$1K |
| A7031 |
Face mask interface, replacement for full face mask, each |
59 |
36 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
653 |
501 |
$1K |
| 90686 |
|
57 |
57 |
$1K |
| 0134A |
|
13 |
13 |
$516.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
36 |
36 |
$381.64 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
563 |
432 |
$338.58 |
| 90656 |
|
13 |
13 |
$241.17 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
15 |
13 |
$206.51 |