| 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 |
1,754 |
1,746 |
$129K |
| E0570 |
Nebulizer, with compressor |
1,411 |
1,408 |
$47K |
| E0601 |
Continuous positive airway pressure (cpap) device |
712 |
704 |
$37K |
| K0001 |
Standard wheelchair |
1,859 |
1,846 |
$25K |
| A4554 |
Disposable underpads, all sizes |
657 |
648 |
$24K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,686 |
1,677 |
$22K |
| 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) |
73 |
73 |
$8K |
| A4335 |
Incontinence supply; miscellaneous |
1,035 |
1,023 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
515 |
510 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
29 |
29 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
428 |
427 |
$1K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
26 |
26 |
$748.74 |
| A7015 |
Aerosol mask, used with dme nebulizer |
398 |
396 |
$480.00 |
| A7035 |
Headgear used with positive airway pressure device |
32 |
32 |
$410.67 |
| A7037 |
Tubing used with positive airway pressure device |
18 |
18 |
$269.11 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
12 |
12 |
$242.93 |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
12 |
12 |
$129.55 |