| 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 |
4,138 |
4,079 |
$254K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,561 |
1,531 |
$133K |
| E0570 |
Nebulizer, with compressor |
5,814 |
5,655 |
$109K |
| A7030 |
Full face mask used with positive airway pressure device, each |
561 |
556 |
$39K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
869 |
865 |
$37K |
| K0001 |
Standard wheelchair |
1,564 |
1,526 |
$37K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
797 |
786 |
$35K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,756 |
2,715 |
$35K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
481 |
476 |
$24K |
| A7031 |
Face mask interface, replacement for full face mask, each |
513 |
510 |
$15K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
930 |
928 |
$12K |
| A7035 |
Headgear used with positive airway pressure device |
1,077 |
1,071 |
$10K |
| A7037 |
Tubing used with positive airway pressure device |
848 |
843 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,579 |
2,550 |
$6K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
374 |
361 |
$5K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
104 |
104 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
65 |
65 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
768 |
765 |
$2K |
| L4397 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf |
12 |
12 |
$944.02 |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
12 |
12 |
$773.65 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
459 |
456 |
$692.48 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
13 |
13 |
$682.33 |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
14 |
14 |
$625.86 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
12 |
12 |
$279.23 |