| 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 |
3,113 |
2,978 |
$111K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,731 |
1,674 |
$12K |
| E0570 |
Nebulizer, with compressor |
339 |
304 |
$12K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
539 |
509 |
$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 |
232 |
155 |
$9K |
| 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 |
230 |
155 |
$8K |
| K0001 |
Standard wheelchair |
372 |
345 |
$4K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
14 |
14 |
$3K |
| A7031 |
Face mask interface, replacement for full face mask, each |
57 |
51 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
186 |
173 |
$368.75 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
13 |
12 |
$125.34 |
| A7035 |
Headgear used with positive airway pressure device |
12 |
12 |
$89.40 |
| A7015 |
Aerosol mask, used with dme nebulizer |
15 |
14 |
$15.21 |