| 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 |
4,895 |
4,035 |
$227K |
| E0570 |
Nebulizer, with compressor |
4,526 |
3,977 |
$125K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,332 |
1,196 |
$88K |
| A7030 |
Full face mask used with positive airway pressure device, each |
572 |
531 |
$48K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,453 |
2,299 |
$35K |
| K0001 |
Standard wheelchair |
2,969 |
2,536 |
$30K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
906 |
778 |
$26K |
| A7037 |
Tubing used with positive airway pressure device |
932 |
862 |
$20K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
956 |
879 |
$5K |
| A7035 |
Headgear used with positive airway pressure device |
243 |
227 |
$5K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
106 |
103 |
$4K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,717 |
2,187 |
$4K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
66 |
42 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,469 |
2,308 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
59 |
52 |
$2K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
64 |
41 |
$1K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
14 |
12 |
$650.14 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
42 |
25 |
$333.97 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
40 |
24 |
$113.52 |