| 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 |
2,871 |
2,595 |
$175K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
1,300 |
1,192 |
$142K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,992 |
1,827 |
$47K |
| E0601 |
Continuous positive airway pressure (cpap) device |
789 |
712 |
$39K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
790 |
726 |
$30K |
| E0570 |
Nebulizer, with compressor |
1,452 |
1,390 |
$28K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
549 |
485 |
$16K |
| A4554 |
Disposable underpads, all sizes |
511 |
491 |
$15K |
| K0001 |
Standard wheelchair |
602 |
548 |
$8K |
| A7037 |
Tubing used with positive airway pressure device |
313 |
281 |
$6K |
| A7030 |
Full face mask used with positive airway pressure device, each |
91 |
74 |
$6K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
213 |
205 |
$6K |
| A7035 |
Headgear used with positive airway pressure device |
157 |
140 |
$4K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
154 |
143 |
$3K |
| A7031 |
Face mask interface, replacement for full face mask, each |
91 |
82 |
$3K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
24 |
24 |
$828.75 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
12 |
12 |
$593.08 |