| 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 |
414 |
410 |
$36K |
| E0570 |
Nebulizer, with compressor |
215 |
215 |
$10K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
142 |
141 |
$10K |
| E0601 |
Continuous positive airway pressure (cpap) device |
165 |
163 |
$8K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
76 |
76 |
$7K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
328 |
328 |
$5K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
126 |
126 |
$4K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
187 |
185 |
$3K |
| A7030 |
Full face mask used with positive airway pressure device, each |
42 |
42 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
105 |
105 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
83 |
83 |
$2K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
15 |
15 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
12 |
12 |
$892.02 |
| K0001 |
Standard wheelchair |
30 |
30 |
$467.11 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
110 |
110 |
$436.79 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
15 |
14 |
$421.38 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
14 |
14 |
$247.63 |