| 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 |
247 |
243 |
$12K |
| E0601 |
Continuous positive airway pressure (cpap) device |
159 |
157 |
$5K |
| A7030 |
Full face mask used with positive airway pressure device, each |
80 |
80 |
$5K |
| A7031 |
Face mask interface, replacement for full face mask, each |
85 |
85 |
$2K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
13 |
13 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
119 |
117 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
59 |
59 |
$2K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
12 |
12 |
$2K |
| E0570 |
Nebulizer, with compressor |
202 |
201 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
122 |
120 |
$1K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
21 |
21 |
$1K |
| A7035 |
Headgear used with positive airway pressure device |
117 |
117 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
235 |
232 |
$893.35 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
14 |
14 |
$660.31 |
| T4541 |
Incontinence product, disposable underpad, large, each |
13 |
13 |
$442.40 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
66 |
66 |
$322.71 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
67 |
67 |
$210.98 |