| 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 |
2,417 |
2,319 |
$221K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,883 |
1,833 |
$103K |
| A7030 |
Full face mask used with positive airway pressure device, each |
128 |
127 |
$12K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
869 |
854 |
$10K |
| 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 |
287 |
158 |
$10K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
156 |
133 |
$8K |
| E0570 |
Nebulizer, with compressor |
72 |
70 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
803 |
787 |
$4K |
| 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 |
164 |
95 |
$4K |
| A7035 |
Headgear used with positive airway pressure device |
151 |
147 |
$3K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
28 |
24 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
117 |
111 |
$2K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
12 |
12 |
$2K |
| A7031 |
Face mask interface, replacement for full face mask, each |
33 |
33 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
73 |
70 |
$940.08 |
| T4541 |
Incontinence product, disposable underpad, large, each |
13 |
13 |
$930.24 |
| E1392 |
Portable oxygen concentrator, rental |
12 |
12 |
$224.48 |