| 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 |
3,926 |
3,733 |
$120K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,818 |
1,700 |
$38K |
| A7030 |
Full face mask used with positive airway pressure device, each |
588 |
565 |
$27K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
617 |
588 |
$25K |
| A7031 |
Face mask interface, replacement for full face mask, each |
995 |
924 |
$23K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,064 |
1,959 |
$17K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
286 |
257 |
$15K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,733 |
1,581 |
$5K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
153 |
142 |
$5K |
| A7035 |
Headgear used with positive airway pressure device |
390 |
369 |
$4K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
31 |
26 |
$4K |
| E0570 |
Nebulizer, with compressor |
89 |
86 |
$3K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
136 |
110 |
$3K |
| A4927 |
Gloves, non-sterile, per 100 |
122 |
111 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
226 |
220 |
$3K |
| A4335 |
Incontinence supply; miscellaneous |
396 |
344 |
$1K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
12 |
12 |
$643.59 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
15 |
15 |
$479.74 |
| A7037 |
Tubing used with positive airway pressure device |
39 |
39 |
$252.32 |