| 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 |
7,020 |
6,782 |
$499K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,638 |
2,612 |
$241K |
| E0570 |
Nebulizer, with compressor |
2,005 |
1,997 |
$99K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,215 |
1,211 |
$92K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,062 |
4,034 |
$70K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,729 |
1,725 |
$66K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,038 |
1,036 |
$52K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
524 |
501 |
$51K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,338 |
1,335 |
$44K |
| A7035 |
Headgear used with positive airway pressure device |
1,905 |
1,903 |
$22K |
| E1392 |
Portable oxygen concentrator, rental |
270 |
269 |
$22K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
675 |
674 |
$18K |
| A7037 |
Tubing used with positive airway pressure device |
1,910 |
1,908 |
$14K |
| K0001 |
Standard wheelchair |
1,051 |
1,040 |
$12K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
394 |
392 |
$8K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
514 |
514 |
$7K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
557 |
557 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,042 |
1,995 |
$4K |
| A4554 |
Disposable underpads, all sizes |
52 |
51 |
$2K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
114 |
114 |
$2K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
25 |
25 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,027 |
1,020 |
$1K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
43 |
40 |
$1K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
12 |
12 |
$715.04 |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
332 |
332 |
$530.85 |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
12 |
12 |
$351.00 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
191 |
191 |
$342.42 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
12 |
12 |
$185.46 |
| E0156 |
Seat attachment, walker |
13 |
13 |
$86.62 |
| A4927 |
Gloves, non-sterile, per 100 |
12 |
12 |
$52.29 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
16 |
16 |
$33.90 |
| A7015 |
Aerosol mask, used with dme nebulizer |
13 |
13 |
$8.97 |