| 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 |
24,569 |
20,496 |
$1.11M |
| E0570 |
Nebulizer, with compressor |
4,884 |
4,135 |
$198K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
9,695 |
8,032 |
$98K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,679 |
2,112 |
$80K |
| 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 |
822 |
466 |
$43K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,929 |
1,627 |
$41K |
| 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 |
822 |
469 |
$37K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,473 |
2,759 |
$28K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,284 |
964 |
$28K |
| A4618 |
Breathing circuits |
2,305 |
1,940 |
$25K |
| A7030 |
Full face mask used with positive airway pressure device, each |
486 |
401 |
$23K |
| K0001 |
Standard wheelchair |
2,180 |
1,708 |
$18K |
| A7035 |
Headgear used with positive airway pressure device |
644 |
545 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,097 |
1,765 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,528 |
1,384 |
$3K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
154 |
121 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
211 |
191 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
352 |
278 |
$1K |
| 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) |
13 |
12 |
$533.20 |
| A7015 |
Aerosol mask, used with dme nebulizer |
355 |
327 |
$378.22 |