| 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 |
4,774 |
4,683 |
$205K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,343 |
2,312 |
$82K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,064 |
1,034 |
$76K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,047 |
1,010 |
$51K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,008 |
987 |
$45K |
| E1392 |
Portable oxygen concentrator, rental |
1,729 |
1,676 |
$42K |
| A7031 |
Face mask interface, replacement for full face mask, each |
970 |
816 |
$27K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
417 |
407 |
$25K |
| A7035 |
Headgear used with positive airway pressure device |
1,068 |
1,034 |
$23K |
| E0570 |
Nebulizer, with compressor |
1,786 |
1,753 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,555 |
2,262 |
$20K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,769 |
1,728 |
$18K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
275 |
246 |
$9K |
| A4670 |
Automatic blood pressure monitor |
140 |
135 |
$7K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
605 |
589 |
$7K |
| A7037 |
Tubing used with positive airway pressure device |
324 |
321 |
$6K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
319 |
284 |
$6K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
99 |
91 |
$4K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
123 |
119 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
637 |
611 |
$2K |
| E0245 |
Tub stool or bench |
24 |
24 |
$2K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
13 |
13 |
$1K |
| T4541 |
Incontinence product, disposable underpad, large, each |
18 |
18 |
$1K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
13 |
13 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
607 |
594 |
$886.86 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
17 |
15 |
$657.83 |
| A4927 |
Gloves, non-sterile, per 100 |
21 |
21 |
$572.42 |
| L0625 |
Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf |
13 |
13 |
$563.36 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
15 |
15 |
$191.95 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
138 |
137 |
$106.02 |