| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
868 |
831 |
$140K |
| E0570 |
Nebulizer, with compressor |
2,434 |
1,857 |
$85K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,314 |
1,203 |
$59K |
| A4670 |
Automatic blood pressure monitor |
891 |
785 |
$49K |
| K0001 |
Standard wheelchair |
3,550 |
2,428 |
$49K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
906 |
595 |
$19K |
| 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 |
378 |
249 |
$15K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
612 |
577 |
$13K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,229 |
1,098 |
$10K |
| 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 |
541 |
315 |
$8K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
747 |
678 |
$2K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
92 |
43 |
$2K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
83 |
56 |
$2K |
| E0156 |
Seat attachment, walker |
177 |
166 |
$1K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
24 |
24 |
$1K |
| L1810 |
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
15 |
14 |
$835.64 |
| A7015 |
Aerosol mask, used with dme nebulizer |
213 |
200 |
$345.94 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
12 |
12 |
$30.98 |