| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
222 |
199 |
$15K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
30 |
24 |
$2K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
58 |
50 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
248 |
234 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
25 |
24 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
25 |
12 |
$180.55 |
| A7037 |
Tubing used with positive airway pressure device |
31 |
28 |
$87.72 |