| 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 |
5,551 |
5,388 |
$385K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,260 |
1,241 |
$112K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,713 |
1,690 |
$87K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,251 |
4,172 |
$54K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
946 |
926 |
$39K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,804 |
1,773 |
$32K |
| K0001 |
Standard wheelchair |
1,641 |
1,612 |
$24K |
| A7031 |
Face mask interface, replacement for full face mask, each |
549 |
543 |
$19K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,714 |
2,663 |
$13K |
| A7035 |
Headgear used with positive airway pressure device |
509 |
492 |
$10K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
24 |
24 |
$3K |
| E0570 |
Nebulizer, with compressor |
95 |
92 |
$3K |
| A4927 |
Gloves, non-sterile, per 100 |
115 |
112 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
172 |
168 |
$2K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
20 |
18 |
$1K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
17 |
12 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
12 |
12 |
$163.08 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
12 |
12 |
$24.68 |