| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
6,664 |
5,796 |
$755K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
9,728 |
8,804 |
$577K |
| E0601 |
Continuous positive airway pressure (cpap) device |
5,994 |
5,164 |
$243K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,172 |
1,086 |
$91K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,255 |
3,807 |
$60K |
| E0570 |
Nebulizer, with compressor |
2,656 |
2,367 |
$56K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
585 |
544 |
$47K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,723 |
1,569 |
$41K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,083 |
993 |
$37K |
| A4554 |
Disposable underpads, all sizes |
2,283 |
2,008 |
$35K |
| A7035 |
Headgear used with positive airway pressure device |
1,726 |
1,606 |
$33K |
| A7037 |
Tubing used with positive airway pressure device |
1,563 |
1,438 |
$28K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
559 |
504 |
$18K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,215 |
2,909 |
$14K |
| K0001 |
Standard wheelchair |
932 |
826 |
$13K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
164 |
147 |
$8K |
| E1392 |
Portable oxygen concentrator, rental |
1,529 |
1,395 |
$6K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
484 |
462 |
$6K |
| 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 |
974 |
899 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,851 |
1,722 |
$5K |
| 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) |
43 |
39 |
$3K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
14 |
12 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
68 |
61 |
$552.71 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
25 |
24 |
$363.29 |
| A7015 |
Aerosol mask, used with dme nebulizer |
98 |
90 |
$108.58 |