| 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 |
1,776 |
1,677 |
$131K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,078 |
981 |
$41K |
| A4335 |
Incontinence supply; miscellaneous |
646 |
586 |
$33K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
360 |
327 |
$26K |
| T2028 |
Specialized supply, not otherwise specified, waiver |
286 |
260 |
$25K |
| A7030 |
Full face mask used with positive airway pressure device, each |
282 |
266 |
$20K |
| A7031 |
Face mask interface, replacement for full face mask, each |
325 |
310 |
$19K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
660 |
613 |
$8K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
82 |
74 |
$8K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
350 |
302 |
$7K |
| E0570 |
Nebulizer, with compressor |
180 |
171 |
$7K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
594 |
563 |
$6K |
| A7035 |
Headgear used with positive airway pressure device |
180 |
164 |
$3K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
65 |
57 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
159 |
150 |
$2K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
12 |
12 |
$649.22 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
38 |
37 |
$309.73 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
12 |
12 |
$28.16 |