| 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 |
1,826 |
1,075 |
$63K |
| E0570 |
Nebulizer, with compressor |
1,049 |
693 |
$50K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
283 |
230 |
$12K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,490 |
896 |
$9K |
| A7030 |
Full face mask used with positive airway pressure device, each |
75 |
59 |
$7K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
292 |
225 |
$5K |
| A7031 |
Face mask interface, replacement for full face mask, each |
138 |
98 |
$4K |
| E0601 |
Continuous positive airway pressure (cpap) device |
93 |
72 |
$4K |
| A7037 |
Tubing used with positive airway pressure device |
106 |
85 |
$2K |
| K0001 |
Standard wheelchair |
171 |
102 |
$1K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
467 |
332 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
246 |
175 |
$853.25 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
35 |
13 |
$826.37 |
| A4554 |
Disposable underpads, all sizes |
12 |
12 |
$810.00 |
| A7035 |
Headgear used with positive airway pressure device |
49 |
42 |
$718.66 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
43 |
24 |
$499.28 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
48 |
39 |
$458.77 |
| A7015 |
Aerosol mask, used with dme nebulizer |
226 |
182 |
$306.86 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
13 |
13 |
$59.80 |
| A4259 |
Lancets, per box of 100 |
212 |
156 |
$51.83 |