| 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 |
10,924 |
8,756 |
$544K |
| E0601 |
Continuous positive airway pressure (cpap) device |
6,083 |
4,952 |
$300K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,164 |
2,785 |
$289K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,372 |
2,940 |
$212K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
5,092 |
4,053 |
$156K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,586 |
2,945 |
$135K |
| A7035 |
Headgear used with positive airway pressure device |
5,679 |
5,014 |
$130K |
| A7037 |
Tubing used with positive airway pressure device |
5,355 |
4,711 |
$119K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
778 |
709 |
$107K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
6,926 |
6,060 |
$37K |
| E0570 |
Nebulizer, with compressor |
3,080 |
2,424 |
$33K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,745 |
2,436 |
$21K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
3,083 |
2,688 |
$19K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,253 |
1,049 |
$17K |
| K0001 |
Standard wheelchair |
2,223 |
1,918 |
$16K |
| 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) |
247 |
221 |
$14K |
| E1392 |
Portable oxygen concentrator, rental |
826 |
617 |
$9K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,356 |
1,918 |
$7K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
404 |
202 |
$7K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
257 |
225 |
$6K |
| 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 |
1,289 |
1,041 |
$5K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
590 |
507 |
$4K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
2,221 |
1,690 |
$2K |
| E1399 |
Durable medical equipment, miscellaneous |
20 |
15 |
$1K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
84 |
74 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,054 |
871 |
$1K |
| E0156 |
Seat attachment, walker |
243 |
167 |
$1K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
59 |
40 |
$561.88 |
| 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 |
28 |
12 |
$382.52 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
13 |
12 |
$272.78 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
63 |
50 |
$248.88 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
52 |
39 |
$212.96 |