| 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 |
1,296 |
1,234 |
$107K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,309 |
1,157 |
$84K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
820 |
743 |
$23K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
206 |
189 |
$20K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
151 |
143 |
$19K |
| A7030 |
Full face mask used with positive airway pressure device, each |
121 |
113 |
$12K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
196 |
160 |
$6K |
| A7031 |
Face mask interface, replacement for full face mask, each |
170 |
158 |
$5K |
| A4554 |
Disposable underpads, all sizes |
202 |
180 |
$5K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
354 |
350 |
$5K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
55 |
51 |
$5K |
| S5170 |
Home delivered meals, including preparation; per meal |
65 |
54 |
$5K |
| A7035 |
Headgear used with positive airway pressure device |
193 |
179 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
799 |
753 |
$3K |
| E0570 |
Nebulizer, with compressor |
47 |
45 |
$3K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
29 |
26 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
146 |
128 |
$714.31 |
| A7037 |
Tubing used with positive airway pressure device |
267 |
249 |
$616.69 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
69 |
63 |
$499.76 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
102 |
82 |
$417.09 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
34 |
33 |
$344.85 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
18 |
12 |
$31.64 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
13 |
13 |
$0.00 |