| 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 |
12,130 |
11,175 |
$872K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,886 |
3,610 |
$181K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,561 |
2,366 |
$169K |
| 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 |
4,905 |
4,511 |
$124K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
974 |
894 |
$122K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
761 |
720 |
$119K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,413 |
1,321 |
$110K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,337 |
3,971 |
$72K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,501 |
1,391 |
$69K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
408 |
403 |
$67K |
| E1392 |
Portable oxygen concentrator, rental |
4,206 |
3,828 |
$64K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,121 |
1,075 |
$42K |
| E0570 |
Nebulizer, with compressor |
869 |
830 |
$41K |
| A7035 |
Headgear used with positive airway pressure device |
1,459 |
1,366 |
$26K |
| A7037 |
Tubing used with positive airway pressure device |
1,106 |
1,032 |
$20K |
| A7031 |
Face mask interface, replacement for full face mask, each |
781 |
735 |
$20K |
| A4927 |
Gloves, non-sterile, per 100 |
945 |
859 |
$13K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
282 |
270 |
$13K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,623 |
2,425 |
$12K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
449 |
424 |
$10K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
475 |
444 |
$8K |
| K0001 |
Standard wheelchair |
128 |
118 |
$6K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
394 |
391 |
$6K |
| 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) |
38 |
36 |
$5K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
484 |
453 |
$5K |
| K0003 |
Lightweight wheelchair |
92 |
92 |
$894.65 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
14 |
14 |
$450.49 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
123 |
115 |
$173.74 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
121 |
109 |
$94.63 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
107 |
107 |
$56.81 |