| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer, with compressor |
1,613 |
1,163 |
$51K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,014 |
763 |
$40K |
| K0001 |
Standard wheelchair |
894 |
741 |
$9K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
110 |
98 |
$9K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
117 |
80 |
$7K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
548 |
388 |
$7K |
| E0601 |
Continuous positive airway pressure (cpap) device |
127 |
113 |
$6K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
606 |
467 |
$5K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
189 |
145 |
$4K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
98 |
76 |
$2K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
64 |
38 |
$953.33 |
| A7015 |
Aerosol mask, used with dme nebulizer |
549 |
389 |
$546.47 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
13 |
13 |
$502.10 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
17 |
12 |
$364.14 |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
177 |
60 |
$0.00 |