| 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 |
4,070 |
3,090 |
$131K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,663 |
3,720 |
$116K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,380 |
1,058 |
$67K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,913 |
1,458 |
$35K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,569 |
1,194 |
$34K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,199 |
3,373 |
$32K |
| E0570 |
Nebulizer, with compressor |
4,287 |
3,345 |
$25K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,650 |
2,050 |
$20K |
| A7035 |
Headgear used with positive airway pressure device |
1,041 |
812 |
$9K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,220 |
1,707 |
$6K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
413 |
318 |
$3K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
393 |
323 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
79 |
59 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
78 |
56 |
$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 |
14 |
13 |
$438.61 |
| 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 |
14 |
13 |
$421.56 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
14 |
12 |
$41.28 |
| 91322 |
|
12 |
12 |
$0.00 |
| 90694 |
|
27 |
27 |
$0.00 |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
178 |
176 |
$0.00 |
| 0064A |
|
121 |
119 |
$0.00 |
| 0011A |
|
27 |
27 |
$0.00 |
| 90674 |
|
62 |
62 |
$0.00 |
| 0012A |
|
16 |
16 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
143 |
143 |
$0.00 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
29 |
26 |
$0.00 |
| 90480 |
|
12 |
12 |
$0.00 |