| 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 |
9,198 |
9,155 |
$586K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,124 |
3,066 |
$124K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,265 |
6,235 |
$87K |
| E0570 |
Nebulizer, with compressor |
2,909 |
2,800 |
$68K |
| 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) |
803 |
771 |
$52K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,668 |
1,658 |
$50K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
180 |
179 |
$33K |
| K0003 |
Lightweight wheelchair |
1,007 |
993 |
$29K |
| A7030 |
Full face mask used with positive airway pressure device, each |
410 |
405 |
$24K |
| A7037 |
Tubing used with positive airway pressure device |
648 |
636 |
$13K |
| K0001 |
Standard wheelchair |
823 |
816 |
$11K |
| A7035 |
Headgear used with positive airway pressure device |
569 |
550 |
$8K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
64 |
64 |
$8K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
626 |
615 |
$8K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,083 |
1,018 |
$5K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
191 |
188 |
$5K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
96 |
92 |
$4K |
| A7031 |
Face mask interface, replacement for full face mask, each |
117 |
110 |
$3K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
78 |
37 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
33 |
28 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
49 |
49 |
$2K |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
16 |
12 |
$834.96 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
38 |
38 |
$218.02 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
301 |
298 |
$149.20 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
105 |
102 |
$124.17 |
| A7015 |
Aerosol mask, used with dme nebulizer |
12 |
12 |
$11.38 |