| 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 |
2,866 |
2,638 |
$306K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,777 |
1,713 |
$110K |
| E0570 |
Nebulizer, with compressor |
1,188 |
1,158 |
$65K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
434 |
420 |
$45K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,972 |
1,906 |
$44K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
695 |
680 |
$22K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,375 |
1,285 |
$21K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
636 |
601 |
$16K |
| A7030 |
Full face mask used with positive airway pressure device, each |
43 |
43 |
$4K |
| A7035 |
Headgear used with positive airway pressure device |
179 |
174 |
$4K |
| L3650 |
Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf |
109 |
107 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
396 |
376 |
$2K |
| E1392 |
Portable oxygen concentrator, rental |
71 |
66 |
$2K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
24 |
24 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
50 |
50 |
$2K |
| 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 |
12 |
12 |
$2K |
| K0001 |
Standard wheelchair |
62 |
62 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
30 |
24 |
$593.17 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
12 |
12 |
$312.10 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
12 |
12 |
$300.69 |