| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
1,397 |
1,373 |
$47K |
| E0570 |
Nebulizer, with compressor |
6,337 |
6,317 |
$37K |
| K0004 |
High strength, lightweight wheelchair |
228 |
227 |
$6K |
| L3807 |
Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
59 |
51 |
$6K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
475 |
475 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
121 |
118 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
283 |
277 |
$1K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
250 |
249 |
$1K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
24 |
24 |
$514.93 |
| A7030 |
Full face mask used with positive airway pressure device, each |
12 |
12 |
$472.84 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
13 |
13 |
$361.73 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
24 |
24 |
$300.50 |
| A7031 |
Face mask interface, replacement for full face mask, each |
12 |
12 |
$290.50 |
| A7037 |
Tubing used with positive airway pressure device |
32 |
32 |
$241.78 |
| A7035 |
Headgear used with positive airway pressure device |
24 |
24 |
$210.66 |
| A4259 |
Lancets, per box of 100 |
12 |
12 |
$35.12 |