| 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 |
5,854 |
5,006 |
$168K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,682 |
4,084 |
$155K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
1,195 |
1,020 |
$77K |
| E0570 |
Nebulizer, with compressor |
1,827 |
1,585 |
$59K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,344 |
2,167 |
$56K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
5,163 |
4,505 |
$51K |
| E1392 |
Portable oxygen concentrator, rental |
3,584 |
3,021 |
$43K |
| A7030 |
Full face mask used with positive airway pressure device, each |
867 |
751 |
$42K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
229 |
189 |
$34K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,281 |
1,160 |
$33K |
| 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 |
636 |
465 |
$32K |
| A7035 |
Headgear used with positive airway pressure device |
2,082 |
1,861 |
$23K |
| K0001 |
Standard wheelchair |
1,298 |
1,172 |
$19K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
912 |
792 |
$18K |
| 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 |
322 |
231 |
$17K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,597 |
5,133 |
$15K |
| A7037 |
Tubing used with positive airway pressure device |
1,452 |
1,318 |
$12K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
296 |
271 |
$10K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,355 |
1,217 |
$5K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
569 |
519 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
433 |
392 |
$4K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
134 |
128 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
235 |
210 |
$2K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
142 |
130 |
$814.21 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
39 |
38 |
$732.83 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
26 |
25 |
$437.59 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
94 |
87 |
$335.53 |
| A7015 |
Aerosol mask, used with dme nebulizer |
69 |
61 |
$67.16 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
13 |
12 |
$21.99 |