| 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 |
15,993 |
15,842 |
$1.16M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,563 |
2,487 |
$809K |
| T4541 |
Incontinence product, disposable underpad, large, each |
13,945 |
13,899 |
$718K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
2,372 |
2,337 |
$703K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
7,520 |
7,091 |
$482K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
8,362 |
7,986 |
$414K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,802 |
4,749 |
$358K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
6,051 |
5,772 |
$339K |
| E0601 |
Continuous positive airway pressure (cpap) device |
5,574 |
5,492 |
$318K |
| 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) |
2,088 |
2,065 |
$292K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,455 |
1,448 |
$163K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
8,800 |
8,744 |
$136K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,882 |
2,881 |
$120K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
955 |
951 |
$92K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,030 |
4,023 |
$86K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,574 |
2,557 |
$80K |
| 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 |
3,018 |
2,999 |
$71K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,666 |
4,604 |
$64K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,255 |
1,118 |
$62K |
| E1392 |
Portable oxygen concentrator, rental |
2,748 |
2,732 |
$56K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,509 |
1,509 |
$56K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
684 |
679 |
$54K |
| E0570 |
Nebulizer, with compressor |
5,597 |
5,523 |
$48K |
| K0001 |
Standard wheelchair |
1,951 |
1,927 |
$45K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
964 |
958 |
$29K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
6,226 |
6,220 |
$28K |
| A7035 |
Headgear used with positive airway pressure device |
2,613 |
2,611 |
$23K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,090 |
2,086 |
$18K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
3,024 |
3,023 |
$9K |
| S9999 |
Sales tax |
3,226 |
3,153 |
$9K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
228 |
228 |
$7K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
207 |
197 |
$6K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,002 |
987 |
$6K |
| A7037 |
Tubing used with positive airway pressure device |
388 |
388 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
24 |
24 |
$576.67 |
| A7015 |
Aerosol mask, used with dme nebulizer |
151 |
147 |
$239.47 |
| A7036 |
Chinstrap used with positive airway pressure device |
14 |
14 |
$97.70 |