| 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 |
3,910 |
3,411 |
$240K |
| A7030 |
Full face mask used with positive airway pressure device, each |
655 |
586 |
$54K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,135 |
1,010 |
$33K |
| A7031 |
Face mask interface, replacement for full face mask, each |
777 |
704 |
$26K |
| E1392 |
Portable oxygen concentrator, rental |
1,448 |
1,296 |
$24K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,951 |
1,685 |
$23K |
| E0570 |
Nebulizer, with compressor |
870 |
705 |
$17K |
| T4541 |
Incontinence product, disposable underpad, large, each |
683 |
659 |
$15K |
| A4927 |
Gloves, non-sterile, per 100 |
708 |
612 |
$10K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
96 |
95 |
$9K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,745 |
1,579 |
$9K |
| A7035 |
Headgear used with positive airway pressure device |
484 |
435 |
$9K |
| E0601 |
Continuous positive airway pressure (cpap) device |
66 |
62 |
$4K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
101 |
88 |
$3K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
48 |
43 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
259 |
234 |
$2K |
| K0001 |
Standard wheelchair |
97 |
84 |
$2K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
16 |
12 |
$332.44 |