| 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 |
4,417 |
3,817 |
$176K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,504 |
1,241 |
$51K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,171 |
3,656 |
$40K |
| E0570 |
Nebulizer, with compressor |
846 |
726 |
$26K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
377 |
339 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
729 |
590 |
$7K |
| A7031 |
Face mask interface, replacement for full face mask, each |
336 |
244 |
$6K |
| A7037 |
Tubing used with positive airway pressure device |
776 |
634 |
$6K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
190 |
153 |
$6K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
285 |
199 |
$6K |
| A7030 |
Full face mask used with positive airway pressure device, each |
179 |
133 |
$5K |
| K0001 |
Standard wheelchair |
376 |
344 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,830 |
1,393 |
$4K |
| K0004 |
High strength, lightweight wheelchair |
232 |
211 |
$4K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
82 |
70 |
$3K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
927 |
738 |
$3K |
| 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 |
133 |
42 |
$2K |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
27 |
12 |
$948.94 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
33 |
25 |
$765.60 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
25 |
24 |
$730.69 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
56 |
51 |
$462.51 |