| 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 |
4,547 |
4,034 |
$358K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
2,170 |
2,056 |
$288K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,074 |
2,736 |
$65K |
| E0570 |
Nebulizer, with compressor |
1,586 |
1,415 |
$42K |
| E0601 |
Continuous positive airway pressure (cpap) device |
520 |
468 |
$22K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
374 |
337 |
$12K |
| K0001 |
Standard wheelchair |
370 |
321 |
$9K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
97 |
86 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
680 |
625 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
52 |
50 |
$3K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
87 |
84 |
$2K |
| A4554 |
Disposable underpads, all sizes |
134 |
126 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
42 |
38 |
$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 |
32 |
13 |
$729.68 |
| 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 |
34 |
13 |
$595.11 |
| A7035 |
Headgear used with positive airway pressure device |
43 |
38 |
$587.75 |
| A7015 |
Aerosol mask, used with dme nebulizer |
31 |
31 |
$158.97 |