| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
1,793 |
1,670 |
$188K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,023 |
2,886 |
$134K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,453 |
1,273 |
$123K |
| A7030 |
Full face mask used with positive airway pressure device, each |
391 |
374 |
$54K |
| A7031 |
Face mask interface, replacement for full face mask, each |
986 |
919 |
$33K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,170 |
1,095 |
$31K |
| E1392 |
Portable oxygen concentrator, rental |
1,668 |
1,588 |
$20K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
113 |
110 |
$18K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,405 |
1,249 |
$18K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
279 |
260 |
$16K |
| A7035 |
Headgear used with positive airway pressure device |
727 |
690 |
$7K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
188 |
187 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,095 |
1,968 |
$6K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
19 |
15 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
30 |
30 |
$1K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
25 |
25 |
$954.77 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
177 |
156 |
$745.71 |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
12 |
12 |
$488.30 |
| L3260 |
Surgical boot/shoe, each |
26 |
26 |
$400.48 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
91 |
86 |
$330.67 |
| A4565 |
Slings |
25 |
25 |
$213.00 |