| 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 |
936 |
846 |
$25K |
| E0601 |
Continuous positive airway pressure (cpap) device |
993 |
944 |
$21K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
268 |
243 |
$12K |
| A7031 |
Face mask interface, replacement for full face mask, each |
442 |
398 |
$9K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
251 |
226 |
$8K |
| A4927 |
Gloves, non-sterile, per 100 |
147 |
137 |
$4K |
| A7030 |
Full face mask used with positive airway pressure device, each |
72 |
65 |
$3K |
| T4541 |
Incontinence product, disposable underpad, large, each |
40 |
40 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
844 |
756 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
193 |
183 |
$2K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
13 |
13 |
$2K |
| A4335 |
Incontinence supply; miscellaneous |
412 |
383 |
$1K |
| A7035 |
Headgear used with positive airway pressure device |
45 |
41 |
$446.39 |