| 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 |
10,955 |
8,289 |
$355K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,181 |
3,796 |
$59K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,706 |
1,321 |
$51K |
| T4542 |
Incontinence product, disposable underpad, small size, each |
970 |
912 |
$35K |
| E0570 |
Nebulizer, with compressor |
1,052 |
763 |
$13K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
756 |
457 |
$12K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
100 |
77 |
$5K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
92 |
66 |
$5K |
| A7035 |
Headgear used with positive airway pressure device |
437 |
327 |
$5K |
| A7030 |
Full face mask used with positive airway pressure device, each |
80 |
55 |
$3K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
79 |
63 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
258 |
200 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,321 |
1,003 |
$2K |
| K0001 |
Standard wheelchair |
29 |
25 |
$1K |
| A7031 |
Face mask interface, replacement for full face mask, each |
52 |
41 |
$1K |
| E1392 |
Portable oxygen concentrator, rental |
269 |
183 |
$965.69 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
465 |
366 |
$847.09 |
| A4927 |
Gloves, non-sterile, per 100 |
14 |
12 |
$160.76 |