| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
6,707 |
6,061 |
$381K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,952 |
3,709 |
$287K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,455 |
3,202 |
$266K |
| A4554 |
Disposable underpads, all sizes |
6,746 |
6,265 |
$265K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
6,152 |
4,782 |
$243K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,272 |
3,001 |
$237K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,687 |
2,653 |
$87K |
| A4927 |
Gloves, non-sterile, per 100 |
6,243 |
5,685 |
$48K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,110 |
890 |
$33K |
| E1392 |
Portable oxygen concentrator, rental |
2,363 |
1,828 |
$25K |
| E0570 |
Nebulizer, with compressor |
1,769 |
1,426 |
$15K |
| 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) |
187 |
143 |
$11K |
| K0001 |
Standard wheelchair |
687 |
582 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,049 |
1,612 |
$7K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
598 |
538 |
$4K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
233 |
208 |
$1K |
| A7030 |
Full face mask used with positive airway pressure device, each |
50 |
42 |
$1K |
| A7035 |
Headgear used with positive airway pressure device |
73 |
58 |
$737.96 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
13 |
12 |
$404.38 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
89 |
75 |
$359.23 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
29 |
26 |
$334.36 |
| E0430 |
Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing |
22 |
13 |
$183.20 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
13 |
13 |
$0.00 |