| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
5,164 |
4,963 |
$595K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,562 |
4,246 |
$318K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,819 |
2,577 |
$128K |
| A4554 |
Disposable underpads, all sizes |
3,244 |
3,099 |
$85K |
| E0570 |
Nebulizer, with compressor |
1,153 |
1,125 |
$49K |
| A7030 |
Full face mask used with positive airway pressure device, each |
598 |
553 |
$45K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,232 |
2,075 |
$32K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
795 |
754 |
$31K |
| A7035 |
Headgear used with positive airway pressure device |
807 |
762 |
$18K |
| A7037 |
Tubing used with positive airway pressure device |
818 |
762 |
$17K |
| K0001 |
Standard wheelchair |
595 |
561 |
$13K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,267 |
1,184 |
$13K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
714 |
672 |
$8K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
150 |
135 |
$3K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
76 |
70 |
$3K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
120 |
115 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
67 |
67 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
26 |
24 |
$623.38 |