| 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 |
3,418 |
3,030 |
$114K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,385 |
1,250 |
$40K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,537 |
1,383 |
$34K |
| E0570 |
Nebulizer, with compressor |
5,661 |
5,067 |
$31K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
442 |
382 |
$10K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
1,530 |
1,440 |
$9K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
304 |
277 |
$7K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,221 |
1,130 |
$5K |
| K0001 |
Standard wheelchair |
617 |
503 |
$3K |
| 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 |
131 |
68 |
$3K |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
986 |
885 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
166 |
146 |
$3K |
| 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 |
132 |
69 |
$3K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
71 |
52 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
91 |
85 |
$2K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
91 |
63 |
$1K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
22 |
14 |
$609.82 |
| A7031 |
Face mask interface, replacement for full face mask, each |
21 |
14 |
$535.97 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
139 |
126 |
$511.42 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
26 |
26 |
$179.96 |
| A4259 |
Lancets, per box of 100 |
246 |
231 |
$77.68 |
| A5120 |
Skin barrier, wipes or swabs, each |
13 |
12 |
$41.52 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
43 |
40 |
$28.93 |