| 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 |
6,419 |
5,571 |
$315K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,725 |
3,199 |
$241K |
| A7030 |
Full face mask used with positive airway pressure device, each |
879 |
818 |
$73K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,362 |
2,128 |
$52K |
| A7037 |
Tubing used with positive airway pressure device |
2,046 |
1,897 |
$42K |
| E0570 |
Nebulizer, with compressor |
3,046 |
2,751 |
$39K |
| A7031 |
Face mask interface, replacement for full face mask, each |
990 |
911 |
$31K |
| A7035 |
Headgear used with positive airway pressure device |
1,489 |
1,364 |
$27K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
288 |
259 |
$26K |
| K0001 |
Standard wheelchair |
2,914 |
2,693 |
$22K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,168 |
1,858 |
$19K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,360 |
3,120 |
$16K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
568 |
509 |
$12K |
| 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 |
3,764 |
3,236 |
$5K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,454 |
1,405 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
406 |
378 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
94 |
94 |
$2K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
263 |
258 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
51 |
50 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
67 |
65 |
$894.68 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
40 |
38 |
$555.86 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
145 |
130 |
$235.76 |
| A4259 |
Lancets, per box of 100 |
430 |
424 |
$120.27 |
| E0156 |
Seat attachment, walker |
13 |
13 |
$105.39 |
| 0013A |
|
80 |
80 |
$0.00 |
| 90756 |
|
13 |
13 |
$0.00 |
| 0012A |
|
133 |
133 |
$0.00 |
| 90688 |
|
230 |
222 |
$0.00 |
| 0011A |
|
145 |
145 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
319 |
311 |
$0.00 |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
44 |
44 |
$0.00 |
| 0134A |
|
14 |
14 |
$0.00 |