| 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 |
3,295 |
3,110 |
$231K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,445 |
3,284 |
$161K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,966 |
2,808 |
$56K |
| A7030 |
Full face mask used with positive airway pressure device, each |
467 |
453 |
$35K |
| E0570 |
Nebulizer, with compressor |
1,617 |
1,571 |
$33K |
| T4541 |
Incontinence product, disposable underpad, large, each |
478 |
469 |
$30K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,643 |
1,512 |
$22K |
| K0001 |
Standard wheelchair |
806 |
772 |
$19K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
849 |
834 |
$19K |
| A7035 |
Headgear used with positive airway pressure device |
1,075 |
1,045 |
$18K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
195 |
177 |
$13K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
134 |
132 |
$12K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
107 |
102 |
$5K |
| 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 |
261 |
259 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
911 |
894 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
347 |
339 |
$3K |
| A7031 |
Face mask interface, replacement for full face mask, each |
79 |
78 |
$2K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
50 |
50 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
659 |
631 |
$2K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
12 |
12 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
27 |
27 |
$567.51 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
12 |
12 |
$258.06 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
47 |
44 |
$153.81 |
| A4927 |
Gloves, non-sterile, per 100 |
12 |
12 |
$147.92 |