| 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 |
3,449 |
3,068 |
$214K |
| E1392 |
Portable oxygen concentrator, rental |
1,295 |
1,186 |
$24K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
702 |
621 |
$19K |
| A7031 |
Face mask interface, replacement for full face mask, each |
553 |
501 |
$17K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,597 |
1,398 |
$17K |
| A7030 |
Full face mask used with positive airway pressure device, each |
148 |
132 |
$11K |
| E0570 |
Nebulizer, with compressor |
556 |
467 |
$10K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
110 |
106 |
$9K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,323 |
1,189 |
$6K |
| A4927 |
Gloves, non-sterile, per 100 |
345 |
304 |
$5K |
| T4541 |
Incontinence product, disposable underpad, large, each |
208 |
194 |
$4K |
| K0001 |
Standard wheelchair |
204 |
178 |
$4K |
| A7035 |
Headgear used with positive airway pressure device |
169 |
154 |
$3K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
34 |
30 |
$3K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
44 |
40 |
$2K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
13 |
12 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
15 |
14 |
$992.60 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
60 |
56 |
$568.32 |