| 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 |
3,943 |
3,495 |
$173K |
| E0570 |
Nebulizer, with compressor |
3,493 |
3,129 |
$103K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,934 |
2,608 |
$75K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,900 |
1,751 |
$62K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,250 |
1,080 |
$59K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,627 |
2,377 |
$31K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,319 |
2,862 |
$22K |
| K0001 |
Standard wheelchair |
1,906 |
1,753 |
$18K |
| A7031 |
Face mask interface, replacement for full face mask, each |
864 |
764 |
$17K |
| A4554 |
Disposable underpads, all sizes |
632 |
555 |
$15K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
88 |
79 |
$10K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
722 |
638 |
$7K |
| A7035 |
Headgear used with positive airway pressure device |
670 |
582 |
$7K |
| A7037 |
Tubing used with positive airway pressure device |
314 |
250 |
$5K |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
15 |
15 |
$4K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
30 |
28 |
$897.59 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
54 |
51 |
$825.16 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
76 |
67 |
$124.37 |