| 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 |
14,406 |
14,355 |
$1.11M |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,349 |
1,346 |
$65K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,251 |
1,187 |
$64K |
| E0601 |
Continuous positive airway pressure (cpap) device |
955 |
940 |
$62K |
| 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 |
2,277 |
2,275 |
$57K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,613 |
3,575 |
$45K |
| E1392 |
Portable oxygen concentrator, rental |
1,781 |
1,777 |
$40K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
429 |
426 |
$29K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
403 |
376 |
$26K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,039 |
1,034 |
$20K |
| E0570 |
Nebulizer, with compressor |
1,844 |
1,796 |
$15K |
| K0001 |
Standard wheelchair |
538 |
531 |
$13K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
202 |
202 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
970 |
969 |
$5K |
| A7031 |
Face mask interface, replacement for full face mask, each |
45 |
45 |
$1K |
| A7030 |
Full face mask used with positive airway pressure device, each |
30 |
30 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
12 |
12 |
$558.28 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
47 |
47 |
$478.82 |
| A7035 |
Headgear used with positive airway pressure device |
23 |
23 |
$262.43 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
63 |
63 |
$178.54 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
12 |
12 |
$70.78 |