| 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 |
886 |
886 |
$27K |
| A4554 |
Disposable underpads, all sizes |
403 |
401 |
$14K |
| A4335 |
Incontinence supply; miscellaneous |
747 |
746 |
$4K |
| E0601 |
Continuous positive airway pressure (cpap) device |
213 |
213 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
362 |
362 |
$2K |
| K0001 |
Standard wheelchair |
164 |
162 |
$1K |
| A7031 |
Face mask interface, replacement for full face mask, each |
12 |
12 |
$507.79 |
| E0570 |
Nebulizer, with compressor |
12 |
12 |
$473.16 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
43 |
41 |
$238.55 |