| 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 |
867 |
867 |
$23K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
79 |
78 |
$9K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
38 |
37 |
$3K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
49 |
49 |
$3K |
| E0570 |
Nebulizer, with compressor |
479 |
469 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
149 |
149 |
$3K |
| T4541 |
Incontinence product, disposable underpad, large, each |
125 |
122 |
$3K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
357 |
357 |
$2K |
| E0601 |
Continuous positive airway pressure (cpap) device |
54 |
54 |
$673.28 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
361 |
358 |
$432.39 |
| A7031 |
Face mask interface, replacement for full face mask, each |
28 |
28 |
$231.00 |