| 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 |
982 |
919 |
$89K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
1,718 |
1,491 |
$70K |
| E0601 |
Continuous positive airway pressure (cpap) device |
399 |
369 |
$53K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
400 |
362 |
$53K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
938 |
806 |
$49K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
840 |
751 |
$38K |
| T4541 |
Incontinence product, disposable underpad, large, each |
819 |
698 |
$33K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
329 |
294 |
$32K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
220 |
142 |
$21K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
186 |
162 |
$20K |
| A4927 |
Gloves, non-sterile, per 100 |
985 |
852 |
$19K |
| A7030 |
Full face mask used with positive airway pressure device, each |
157 |
141 |
$18K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
197 |
180 |
$15K |
| A7035 |
Headgear used with positive airway pressure device |
460 |
421 |
$12K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
101 |
87 |
$7K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
52 |
40 |
$6K |
| E1392 |
Portable oxygen concentrator, rental |
483 |
440 |
$6K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
109 |
104 |
$5K |
| E0570 |
Nebulizer, with compressor |
173 |
163 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,326 |
361 |
$4K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
57 |
42 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
30 |
24 |
$475.86 |