| 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 |
14,331 |
12,154 |
$433K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,388 |
3,731 |
$93K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,369 |
2,022 |
$92K |
| E0570 |
Nebulizer, with compressor |
3,549 |
3,152 |
$53K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,595 |
2,203 |
$47K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,198 |
2,693 |
$46K |
| E1392 |
Portable oxygen concentrator, rental |
3,903 |
3,097 |
$40K |
| K0001 |
Standard wheelchair |
4,997 |
4,195 |
$39K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,132 |
4,532 |
$38K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
5,315 |
4,441 |
$33K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,231 |
1,042 |
$31K |
| A7035 |
Headgear used with positive airway pressure device |
2,151 |
1,824 |
$17K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,020 |
865 |
$10K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,096 |
3,488 |
$9K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
359 |
322 |
$9K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
63 |
55 |
$9K |
| 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 |
301 |
116 |
$5K |
| A7037 |
Tubing used with positive airway pressure device |
790 |
675 |
$4K |
| 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 |
303 |
117 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,243 |
1,978 |
$4K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
211 |
186 |
$3K |
| 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) |
104 |
90 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
850 |
741 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
509 |
434 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
143 |
131 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,806 |
1,595 |
$1K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
79 |
63 |
$1K |
| 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 |
49 |
41 |
$477.25 |
| K0006 |
Heavy duty wheelchair |
13 |
12 |
$303.96 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
18 |
12 |
$106.10 |
| E0156 |
Seat attachment, walker |
13 |
12 |
$42.52 |