| 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 |
16,694 |
13,695 |
$466K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,603 |
1,402 |
$75K |
| 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 |
123 |
119 |
$57K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,816 |
2,361 |
$54K |
| E1392 |
Portable oxygen concentrator, rental |
4,841 |
3,790 |
$47K |
| E0570 |
Nebulizer, with compressor |
3,568 |
3,129 |
$46K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,256 |
5,189 |
$41K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,096 |
1,789 |
$38K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,644 |
2,206 |
$37K |
| K0001 |
Standard wheelchair |
4,182 |
3,281 |
$25K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
118 |
111 |
$19K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,136 |
2,653 |
$19K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
476 |
398 |
$12K |
| A7035 |
Headgear used with positive airway pressure device |
1,375 |
1,174 |
$11K |
| A7031 |
Face mask interface, replacement for full face mask, each |
566 |
484 |
$9K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,252 |
2,767 |
$7K |
| 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 |
296 |
153 |
$7K |
| 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 |
302 |
156 |
$6K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,501 |
2,150 |
$5K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
316 |
259 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,083 |
1,797 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
71 |
56 |
$1K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
13 |
12 |
$511.04 |
| A7037 |
Tubing used with positive airway pressure device |
57 |
55 |
$430.38 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
18 |
13 |
$308.63 |