| 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 |
1,583 |
1,560 |
$107K |
| E0601 |
Continuous positive airway pressure (cpap) device |
262 |
261 |
$28K |
| E0570 |
Nebulizer, with compressor |
591 |
588 |
$21K |
| A7030 |
Full face mask used with positive airway pressure device, each |
255 |
253 |
$18K |
| L2114 |
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment |
66 |
66 |
$17K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
781 |
773 |
$14K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
452 |
447 |
$13K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
577 |
577 |
$9K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
195 |
182 |
$7K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
230 |
230 |
$6K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
84 |
83 |
$6K |
| A7035 |
Headgear used with positive airway pressure device |
489 |
488 |
$5K |
| A7037 |
Tubing used with positive airway pressure device |
511 |
511 |
$4K |
| A7031 |
Face mask interface, replacement for full face mask, each |
103 |
103 |
$3K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
26 |
25 |
$2K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
65 |
64 |
$2K |
| K0001 |
Standard wheelchair |
87 |
87 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
807 |
804 |
$1K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
14 |
14 |
$559.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
35 |
35 |
$113.10 |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
12 |
12 |
$21.96 |
| A7015 |
Aerosol mask, used with dme nebulizer |
15 |
15 |
$13.48 |