| 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 |
438 |
415 |
$38K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
293 |
277 |
$33K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
454 |
414 |
$26K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
299 |
276 |
$25K |
| E0601 |
Continuous positive airway pressure (cpap) device |
470 |
448 |
$20K |
| A7030 |
Full face mask used with positive airway pressure device, each |
171 |
167 |
$20K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
344 |
340 |
$15K |
| A7031 |
Face mask interface, replacement for full face mask, each |
166 |
163 |
$8K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
86 |
82 |
$7K |
| T4541 |
Incontinence product, disposable underpad, large, each |
117 |
115 |
$4K |
| A7035 |
Headgear used with positive airway pressure device |
163 |
159 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
506 |
495 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
25 |
25 |
$354.39 |