| 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 |
611 |
569 |
$31K |
| E0601 |
Continuous positive airway pressure (cpap) device |
669 |
531 |
$18K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
209 |
194 |
$13K |
| T4541 |
Incontinence product, disposable underpad, large, each |
240 |
226 |
$12K |
| A7030 |
Full face mask used with positive airway pressure device, each |
204 |
175 |
$11K |
| E0570 |
Nebulizer, with compressor |
670 |
609 |
$10K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
851 |
630 |
$8K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
229 |
205 |
$8K |
| 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 |
383 |
333 |
$7K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
265 |
233 |
$6K |
| A7035 |
Headgear used with positive airway pressure device |
392 |
352 |
$5K |
| A7031 |
Face mask interface, replacement for full face mask, each |
173 |
140 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
370 |
281 |
$4K |
| A7037 |
Tubing used with positive airway pressure device |
226 |
209 |
$3K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
69 |
42 |
$3K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
94 |
82 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
174 |
165 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
640 |
551 |
$2K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
13 |
12 |
$450.63 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
24 |
24 |
$349.67 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
46 |
43 |
$330.44 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
39 |
28 |
$277.41 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
13 |
13 |
$259.44 |