| 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 |
5,689 |
5,303 |
$499K |
| E0570 |
Nebulizer, with compressor |
4,283 |
4,064 |
$397K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,104 |
2,927 |
$193K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,174 |
1,116 |
$127K |
| 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) |
797 |
771 |
$101K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
520 |
463 |
$89K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
2,114 |
1,784 |
$78K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,272 |
3,981 |
$72K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
538 |
506 |
$67K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
1,703 |
1,642 |
$59K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
303 |
285 |
$51K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
889 |
823 |
$46K |
| A7035 |
Headgear used with positive airway pressure device |
1,977 |
1,886 |
$45K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
229 |
227 |
$44K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
544 |
508 |
$35K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
459 |
444 |
$22K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
129 |
124 |
$15K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
174 |
168 |
$13K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
114 |
106 |
$12K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
284 |
255 |
$12K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,706 |
2,604 |
$12K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
103 |
99 |
$10K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,108 |
1,066 |
$10K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
318 |
310 |
$9K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
65 |
64 |
$8K |
| A7037 |
Tubing used with positive airway pressure device |
2,077 |
1,984 |
$6K |
| K0001 |
Standard wheelchair |
230 |
214 |
$6K |
| A4554 |
Disposable underpads, all sizes |
118 |
115 |
$5K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
38 |
37 |
$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 |
79 |
53 |
$3K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
31 |
27 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
42 |
38 |
$2K |
| S5170 |
Home delivered meals, including preparation; per meal |
30 |
24 |
$2K |
| A7031 |
Face mask interface, replacement for full face mask, each |
58 |
56 |
$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 |
78 |
52 |
$2K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
14 |
14 |
$772.00 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
104 |
99 |
$360.00 |
| L3260 |
Surgical boot/shoe, each |
14 |
13 |
$240.17 |
| A4565 |
Slings |
39 |
39 |
$222.61 |