| 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 |
2,889 |
2,730 |
$262K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,566 |
1,465 |
$100K |
| E0570 |
Nebulizer, with compressor |
2,074 |
2,054 |
$97K |
| A7030 |
Full face mask used with positive airway pressure device, each |
470 |
470 |
$37K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
788 |
703 |
$32K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
1,121 |
1,118 |
$30K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,334 |
1,266 |
$27K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
432 |
409 |
$18K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
105 |
105 |
$18K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
681 |
644 |
$12K |
| A7035 |
Headgear used with positive airway pressure device |
728 |
726 |
$10K |
| K0001 |
Standard wheelchair |
544 |
511 |
$10K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
230 |
228 |
$9K |
| A7037 |
Tubing used with positive airway pressure device |
700 |
699 |
$8K |
| E1392 |
Portable oxygen concentrator, rental |
109 |
103 |
$7K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
452 |
440 |
$7K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
66 |
65 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
95 |
95 |
$5K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
76 |
76 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
935 |
930 |
$3K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
15 |
15 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
543 |
542 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
717 |
714 |
$1K |
| A7031 |
Face mask interface, replacement for full face mask, each |
25 |
25 |
$803.57 |
| A7015 |
Aerosol mask, used with dme nebulizer |
32 |
31 |
$33.56 |