| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
8,750 |
8,511 |
$1.02M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
10,130 |
9,721 |
$621K |
| A4554 |
Disposable underpads, all sizes |
4,557 |
4,441 |
$106K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,239 |
5,977 |
$95K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,561 |
1,394 |
$58K |
| E0570 |
Nebulizer, with compressor |
2,713 |
2,626 |
$55K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,799 |
1,705 |
$51K |
| A7030 |
Full face mask used with positive airway pressure device, each |
515 |
497 |
$37K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,303 |
1,188 |
$33K |
| K0001 |
Standard wheelchair |
2,031 |
1,933 |
$28K |
| A7035 |
Headgear used with positive airway pressure device |
1,189 |
1,131 |
$23K |
| A7037 |
Tubing used with positive airway pressure device |
1,375 |
1,313 |
$23K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,429 |
2,338 |
$14K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
131 |
126 |
$7K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
798 |
763 |
$6K |
| 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) |
101 |
88 |
$6K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
57 |
53 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
733 |
700 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
27 |
27 |
$311.74 |