| 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 |
4,996 |
4,499 |
$165K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,854 |
2,573 |
$42K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,594 |
1,452 |
$40K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
29 |
26 |
$33K |
| E0570 |
Nebulizer, with compressor |
2,577 |
2,353 |
$32K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,114 |
1,031 |
$28K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,461 |
751 |
$11K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
371 |
352 |
$10K |
| K0001 |
Standard wheelchair |
774 |
724 |
$9K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
136 |
127 |
$8K |
| E1392 |
Portable oxygen concentrator, rental |
262 |
241 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
97 |
88 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
354 |
333 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,191 |
1,070 |
$1K |
| A7030 |
Full face mask used with positive airway pressure device, each |
27 |
25 |
$921.64 |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
102 |
81 |
$655.91 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
40 |
37 |
$519.35 |
| A7035 |
Headgear used with positive airway pressure device |
47 |
40 |
$231.07 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
159 |
154 |
$140.40 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
50 |
39 |
$137.13 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
341 |
312 |
$100.60 |