| 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 |
8,928 |
7,148 |
$442K |
| A7031 |
Face mask interface, replacement for full face mask, each |
5,633 |
4,652 |
$176K |
| E0601 |
Continuous positive airway pressure (cpap) device |
5,434 |
4,508 |
$173K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,745 |
2,256 |
$154K |
| 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 |
2,151 |
1,160 |
$93K |
| 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 |
2,124 |
1,150 |
$88K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,669 |
2,201 |
$62K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,347 |
1,960 |
$44K |
| E1392 |
Portable oxygen concentrator, rental |
2,702 |
2,135 |
$36K |
| A7035 |
Headgear used with positive airway pressure device |
2,621 |
2,130 |
$29K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
572 |
271 |
$29K |
| E0570 |
Nebulizer, with compressor |
1,138 |
819 |
$19K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,843 |
1,313 |
$15K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,815 |
4,014 |
$13K |
| A7037 |
Tubing used with positive airway pressure device |
1,325 |
1,048 |
$12K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
493 |
397 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
14 |
12 |
$291.22 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
18 |
13 |
$228.40 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
17 |
12 |
$203.50 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
43 |
38 |
$172.02 |