| 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 |
4,582 |
4,535 |
$336K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,446 |
1,417 |
$218K |
| E0570 |
Nebulizer, with compressor |
2,230 |
2,214 |
$139K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,783 |
1,770 |
$81K |
| A7030 |
Full face mask used with positive airway pressure device, each |
674 |
668 |
$44K |
| A4554 |
Disposable underpads, all sizes |
1,220 |
1,198 |
$43K |
| K0001 |
Standard wheelchair |
1,648 |
1,632 |
$27K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
144 |
142 |
$22K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,195 |
1,184 |
$14K |
| A4335 |
Incontinence supply; miscellaneous |
1,986 |
1,946 |
$11K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,797 |
1,774 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,670 |
1,654 |
$6K |
| A7035 |
Headgear used with positive airway pressure device |
457 |
453 |
$5K |
| A7037 |
Tubing used with positive airway pressure device |
240 |
237 |
$5K |
| E1392 |
Portable oxygen concentrator, rental |
1,238 |
1,233 |
$4K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
115 |
114 |
$4K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
26 |
26 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
118 |
116 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,706 |
1,684 |
$2K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
27 |
25 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
26 |
26 |
$2K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
39 |
39 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
30 |
28 |
$790.40 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
1,065 |
1,058 |
$622.06 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
341 |
340 |
$608.54 |
| A7031 |
Face mask interface, replacement for full face mask, each |
12 |
12 |
$322.50 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
114 |
113 |
$287.41 |
| A4322 |
Irrigation syringe, bulb or piston, each |
13 |
12 |
$135.36 |