| 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 |
18,247 |
13,458 |
$718K |
| E0601 |
Continuous positive airway pressure (cpap) device |
10,914 |
8,771 |
$382K |
| E0570 |
Nebulizer, with compressor |
9,093 |
6,650 |
$139K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,012 |
1,549 |
$138K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
7,659 |
6,197 |
$129K |
| 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) |
1,862 |
1,537 |
$124K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,423 |
2,574 |
$91K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,958 |
6,011 |
$65K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,295 |
1,733 |
$63K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,090 |
839 |
$49K |
| A7035 |
Headgear used with positive airway pressure device |
2,865 |
2,155 |
$39K |
| 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 |
3,076 |
2,243 |
$33K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
939 |
666 |
$32K |
| E1392 |
Portable oxygen concentrator, rental |
2,336 |
1,794 |
$30K |
| E1086 |
Hemi-wheelchair detachable arms desk or full length, swing away detachable footrests |
337 |
300 |
$27K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,390 |
1,861 |
$26K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
860 |
681 |
$24K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,943 |
3,793 |
$17K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,640 |
1,268 |
$15K |
| E1140 |
Wheelchair, detachable arms, desk or full length, swing away detachable footrests |
520 |
455 |
$15K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
291 |
252 |
$12K |
| E1093 |
Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests |
130 |
115 |
$11K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
404 |
292 |
$9K |
| A7037 |
Tubing used with positive airway pressure device |
515 |
424 |
$7K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
158 |
83 |
$6K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
201 |
159 |
$5K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,047 |
828 |
$5K |
| E0184 |
Dry pressure mattress |
280 |
207 |
$3K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
68 |
50 |
$3K |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
30 |
12 |
$2K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
17 |
12 |
$2K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
19 |
14 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,669 |
1,272 |
$862.39 |
| 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 |
33 |
12 |
$754.90 |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
58 |
36 |
$710.07 |
| A7015 |
Aerosol mask, used with dme nebulizer |
863 |
694 |
$692.28 |
| K0001 |
Standard wheelchair |
495 |
349 |
$561.08 |
| E0156 |
Seat attachment, walker |
43 |
30 |
$232.81 |
| K0002 |
Standard hemi (low seat) wheelchair |
49 |
36 |
$0.00 |
| K0052 |
Swingaway, detachable footrests, replacement only, each |
25 |
12 |
$0.00 |