| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
5,464 |
4,253 |
$522K |
| E0651 |
Pneumatic compressor, segmental home model without calibrated gradient pressure |
712 |
652 |
$46K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
627 |
566 |
$43K |
| A6549 |
Gradient compression garment, not otherwise specified, for daytime use, each |
562 |
115 |
$39K |
| A4554 |
Disposable underpads, all sizes |
2,367 |
1,754 |
$37K |
| E0601 |
Continuous positive airway pressure (cpap) device |
646 |
562 |
$29K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
291 |
183 |
$20K |
| E0570 |
Nebulizer, with compressor |
731 |
652 |
$13K |
| A7037 |
Tubing used with positive airway pressure device |
412 |
368 |
$6K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
127 |
113 |
$5K |
| A7035 |
Headgear used with positive airway pressure device |
214 |
191 |
$3K |
| A7030 |
Full face mask used with positive airway pressure device, each |
48 |
42 |
$3K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
68 |
56 |
$3K |
| K0001 |
Standard wheelchair |
127 |
118 |
$1K |
| 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 |
26 |
12 |
$1K |
| 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 |
24 |
12 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
114 |
97 |
$634.58 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
84 |
74 |
$258.12 |