| 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 |
3,593 |
2,776 |
$101K |
| E0570 |
Nebulizer, with compressor |
1,106 |
819 |
$18K |
| E1392 |
Portable oxygen concentrator, rental |
824 |
706 |
$16K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,445 |
1,107 |
$10K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,519 |
1,111 |
$9K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
421 |
313 |
$8K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
5,299 |
1,796 |
$6K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
537 |
431 |
$4K |
| K0003 |
Lightweight wheelchair |
622 |
526 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
623 |
412 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
59 |
41 |
$600.89 |
| E1240 |
Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest |
80 |
40 |
$487.24 |
| A7035 |
Headgear used with positive airway pressure device |
144 |
107 |
$404.55 |
| A7037 |
Tubing used with positive airway pressure device |
167 |
128 |
$273.35 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
27 |
15 |
$253.74 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
16 |
13 |
$198.12 |
| A7031 |
Face mask interface, replacement for full face mask, each |
20 |
13 |
$163.59 |
| L8000 |
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type |
117 |
104 |
$162.04 |
| 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 |
26 |
24 |
$148.88 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
108 |
85 |
$79.01 |
| E0156 |
Seat attachment, walker |
13 |
12 |
$22.41 |
| A7015 |
Aerosol mask, used with dme nebulizer |
24 |
12 |
$6.00 |