| 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 |
1,200 |
1,030 |
$52K |
| E0570 |
Nebulizer, with compressor |
1,118 |
951 |
$40K |
| E0601 |
Continuous positive airway pressure (cpap) device |
726 |
662 |
$37K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
170 |
144 |
$13K |
| T4541 |
Incontinence product, disposable underpad, large, each |
586 |
495 |
$12K |
| E1392 |
Portable oxygen concentrator, rental |
352 |
322 |
$11K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
246 |
215 |
$8K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
521 |
443 |
$7K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
80 |
75 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
274 |
234 |
$3K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
37 |
37 |
$2K |
| K0001 |
Standard wheelchair |
86 |
76 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
106 |
103 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
506 |
435 |
$1K |
| A7035 |
Headgear used with positive airway pressure device |
49 |
48 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
44 |
37 |
$799.17 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
53 |
51 |
$387.98 |
| A7015 |
Aerosol mask, used with dme nebulizer |
140 |
131 |
$192.32 |