| 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 |
1,385 |
1,215 |
$152K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,249 |
1,238 |
$73K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
337 |
335 |
$34K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,268 |
1,260 |
$25K |
| E0570 |
Nebulizer, with compressor |
491 |
491 |
$21K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
555 |
544 |
$17K |
| A7030 |
Full face mask used with positive airway pressure device, each |
155 |
153 |
$17K |
| E1392 |
Portable oxygen concentrator, rental |
335 |
297 |
$8K |
| L3650 |
Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf |
190 |
187 |
$6K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
139 |
139 |
$6K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
169 |
166 |
$6K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
58 |
58 |
$6K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
268 |
255 |
$6K |
| K0001 |
Standard wheelchair |
181 |
179 |
$6K |
| A7035 |
Headgear used with positive airway pressure device |
188 |
185 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
51 |
50 |
$3K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
91 |
73 |
$3K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
79 |
79 |
$3K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
103 |
102 |
$3K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
90 |
90 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
108 |
108 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
192 |
187 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
14 |
14 |
$189.52 |