| 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 |
1,300 |
1,198 |
$51K |
| E0601 |
Continuous positive airway pressure (cpap) device |
420 |
403 |
$20K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
976 |
879 |
$13K |
| A4927 |
Gloves, non-sterile, per 100 |
539 |
491 |
$8K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
64 |
63 |
$7K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
35 |
27 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
117 |
112 |
$3K |
| E0570 |
Nebulizer, with compressor |
130 |
108 |
$2K |
| K0001 |
Standard wheelchair |
107 |
83 |
$784.98 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
58 |
58 |
$132.92 |