| 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 |
315 |
313 |
$20K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
25 |
25 |
$6K |
| T4541 |
Incontinence product, disposable underpad, large, each |
89 |
89 |
$5K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
12 |
12 |
$4K |
| E0601 |
Continuous positive airway pressure (cpap) device |
62 |
61 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
185 |
182 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
69 |
67 |
$2K |
| A7031 |
Face mask interface, replacement for full face mask, each |
67 |
66 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
36 |
36 |
$2K |
| E0570 |
Nebulizer, with compressor |
212 |
211 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
38 |
38 |
$2K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
52 |
52 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
196 |
193 |
$715.65 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
27 |
26 |
$587.09 |
| A7035 |
Headgear used with positive airway pressure device |
68 |
67 |
$563.38 |
| A7037 |
Tubing used with positive airway pressure device |
33 |
33 |
$245.62 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
31 |
31 |
$165.60 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
33 |
33 |
$128.64 |