| 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 |
2,600 |
2,349 |
$264K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,463 |
4,218 |
$257K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,021 |
959 |
$120K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,371 |
4,127 |
$93K |
| E0570 |
Nebulizer, with compressor |
1,800 |
1,657 |
$79K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,931 |
1,820 |
$70K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
863 |
838 |
$53K |
| A4670 |
Automatic blood pressure monitor |
836 |
808 |
$52K |
| A7035 |
Headgear used with positive airway pressure device |
1,959 |
1,858 |
$49K |
| T4541 |
Incontinence product, disposable underpad, large, each |
754 |
714 |
$46K |
| 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 |
1,263 |
1,181 |
$42K |
| K0001 |
Standard wheelchair |
1,119 |
1,059 |
$30K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
620 |
581 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,912 |
2,758 |
$18K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,256 |
1,198 |
$16K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
297 |
289 |
$15K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
105 |
103 |
$14K |
| A7031 |
Face mask interface, replacement for full face mask, each |
294 |
280 |
$11K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
122 |
121 |
$9K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
209 |
198 |
$7K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
42 |
40 |
$5K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
43 |
36 |
$3K |
| A4927 |
Gloves, non-sterile, per 100 |
258 |
252 |
$3K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
26 |
26 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
43 |
37 |
$2K |
| A4452 |
Tape, waterproof, per 18 square inches |
124 |
115 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
51 |
50 |
$1K |
| E0156 |
Seat attachment, walker |
40 |
40 |
$571.29 |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
14 |
13 |
$521.75 |
| A7036 |
Chinstrap used with positive airway pressure device |
29 |
25 |
$288.24 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
38 |
38 |
$153.38 |
| A7015 |
Aerosol mask, used with dme nebulizer |
20 |
12 |
$29.32 |