| 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 |
3,661 |
3,391 |
$113K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,331 |
2,133 |
$57K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
640 |
533 |
$36K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,143 |
2,915 |
$30K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,463 |
1,366 |
$29K |
| K0001 |
Standard wheelchair |
1,671 |
1,580 |
$16K |
| A7030 |
Full face mask used with positive airway pressure device, each |
422 |
356 |
$16K |
| A7031 |
Face mask interface, replacement for full face mask, each |
673 |
413 |
$8K |
| A7037 |
Tubing used with positive airway pressure device |
745 |
631 |
$7K |
| E0570 |
Nebulizer, with compressor |
361 |
343 |
$5K |
| A7035 |
Headgear used with positive airway pressure device |
902 |
772 |
$5K |
| K0003 |
Lightweight wheelchair |
318 |
315 |
$3K |
| 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) |
38 |
36 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
801 |
659 |
$2K |
| E1392 |
Portable oxygen concentrator, rental |
82 |
81 |
$1K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
28 |
25 |
$985.98 |
| A4554 |
Disposable underpads, all sizes |
18 |
17 |
$867.52 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
13 |
12 |
$450.71 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
109 |
85 |
$245.22 |