| 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 |
16,909 |
14,452 |
$461K |
| E1392 |
Portable oxygen concentrator, rental |
4,600 |
3,725 |
$45K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,236 |
2,786 |
$43K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,042 |
6,233 |
$40K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,374 |
1,185 |
$35K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,684 |
2,259 |
$34K |
| E0570 |
Nebulizer, with compressor |
3,740 |
3,366 |
$30K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,192 |
1,852 |
$24K |
| K0001 |
Standard wheelchair |
3,556 |
2,996 |
$19K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
967 |
821 |
$17K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,457 |
2,955 |
$14K |
| 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) |
331 |
304 |
$12K |
| A7035 |
Headgear used with positive airway pressure device |
1,409 |
1,181 |
$7K |
| A7031 |
Face mask interface, replacement for full face mask, each |
728 |
623 |
$7K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
29 |
25 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,955 |
2,478 |
$5K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
117 |
110 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,454 |
1,232 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
110 |
97 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
137 |
132 |
$773.73 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
20 |
13 |
$416.70 |
| 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 |
24 |
12 |
$385.91 |
| 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 |
24 |
12 |
$377.47 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
112 |
57 |
$244.44 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
21 |
14 |
$221.84 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
62 |
42 |
$203.61 |
| E0156 |
Seat attachment, walker |
39 |
38 |
$192.39 |
| A7015 |
Aerosol mask, used with dme nebulizer |
123 |
110 |
$103.80 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
13 |
13 |
$35.08 |