| 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 |
7,540 |
7,163 |
$219K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,177 |
1,118 |
$67K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,598 |
1,506 |
$63K |
| 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 |
3,293 |
3,179 |
$59K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,846 |
1,739 |
$33K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
584 |
569 |
$32K |
| E0601 |
Continuous positive airway pressure (cpap) device |
911 |
832 |
$25K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
200 |
185 |
$25K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,737 |
2,594 |
$19K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,191 |
2,029 |
$16K |
| E0570 |
Nebulizer, with compressor |
2,268 |
2,132 |
$15K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,457 |
3,261 |
$10K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
505 |
474 |
$9K |
| A7035 |
Headgear used with positive airway pressure device |
888 |
832 |
$8K |
| K0004 |
High strength, lightweight wheelchair |
2,021 |
1,905 |
$6K |
| A4927 |
Gloves, non-sterile, per 100 |
575 |
488 |
$6K |
| A7037 |
Tubing used with positive airway pressure device |
955 |
884 |
$6K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
44 |
43 |
$5K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
267 |
217 |
$4K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
156 |
123 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
3,437 |
1,725 |
$2K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
12 |
12 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
43 |
39 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
58 |
55 |
$781.19 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
2,538 |
1,285 |
$752.30 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
109 |
108 |
$211.84 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
13 |
12 |
$128.59 |