| 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 |
2,703 |
2,655 |
$287K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,656 |
1,612 |
$158K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,697 |
2,654 |
$61K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,024 |
1,973 |
$58K |
| 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) |
221 |
218 |
$47K |
| K0001 |
Standard wheelchair |
223 |
213 |
$13K |
| T4541 |
Incontinence product, disposable underpad, large, each |
326 |
326 |
$12K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
111 |
110 |
$4K |
| E0570 |
Nebulizer, with compressor |
35 |
33 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
102 |
102 |
$3K |
| A4670 |
Automatic blood pressure monitor |
24 |
24 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
101 |
101 |
$2K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
40 |
39 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
99 |
99 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
26 |
26 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
99 |
99 |
$1K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
12 |
12 |
$136.22 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
21 |
21 |
$14.69 |
| A4335 |
Incontinence supply; miscellaneous |
17 |
17 |
$12.66 |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
14 |
14 |
$0.00 |