| 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 |
11,741 |
11,419 |
$1.13M |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,469 |
1,447 |
$166K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,326 |
2,269 |
$136K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,803 |
1,764 |
$86K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,262 |
1,200 |
$65K |
| E0570 |
Nebulizer, with compressor |
910 |
866 |
$55K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,496 |
3,370 |
$55K |
| A7035 |
Headgear used with positive airway pressure device |
1,835 |
1,817 |
$43K |
| A7037 |
Tubing used with positive airway pressure device |
1,811 |
1,781 |
$42K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
317 |
303 |
$36K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,385 |
2,333 |
$27K |
| T4541 |
Incontinence product, disposable underpad, large, each |
406 |
401 |
$27K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
276 |
273 |
$20K |
| E1392 |
Portable oxygen concentrator, rental |
1,379 |
1,330 |
$18K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
89 |
89 |
$16K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,518 |
1,499 |
$16K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
268 |
266 |
$16K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
116 |
115 |
$15K |
| 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 |
509 |
487 |
$13K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
88 |
88 |
$10K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
660 |
639 |
$8K |
| K0001 |
Standard wheelchair |
349 |
343 |
$7K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
75 |
75 |
$6K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
26 |
26 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
977 |
951 |
$4K |
| K0003 |
Lightweight wheelchair |
80 |
74 |
$3K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
40 |
40 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
195 |
192 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
13 |
12 |
$168.30 |