| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
3,563 |
3,436 |
$231K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,401 |
2,308 |
$218K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,681 |
2,406 |
$163K |
| E0570 |
Nebulizer, with compressor |
4,053 |
3,792 |
$100K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
618 |
577 |
$95K |
| A7037 |
Tubing used with positive airway pressure device |
3,210 |
3,096 |
$71K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,771 |
1,700 |
$61K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,600 |
1,447 |
$50K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,576 |
1,499 |
$45K |
| A7035 |
Headgear used with positive airway pressure device |
1,927 |
1,844 |
$39K |
| K0001 |
Standard wheelchair |
2,034 |
1,874 |
$30K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,838 |
1,770 |
$26K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
412 |
393 |
$24K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,138 |
3,002 |
$20K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
310 |
284 |
$14K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,516 |
1,456 |
$10K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
688 |
631 |
$10K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
849 |
811 |
$7K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
586 |
534 |
$6K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
511 |
345 |
$5K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
12 |
12 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
255 |
208 |
$4K |
| E1392 |
Portable oxygen concentrator, rental |
785 |
719 |
$4K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
433 |
407 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,792 |
1,728 |
$2K |
| K0003 |
Lightweight wheelchair |
115 |
104 |
$1K |
| 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 |
38 |
25 |
$782.26 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
14 |
14 |
$556.85 |
| 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 |
38 |
25 |
$438.10 |
| A4259 |
Lancets, per box of 100 |
390 |
368 |
$200.38 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
44 |
41 |
$62.63 |
| A4258 |
Spring-powered device for lancet, each |
14 |
12 |
$7.60 |