| 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 |
4,403 |
3,584 |
$272K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,369 |
2,083 |
$123K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,448 |
1,187 |
$104K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,613 |
2,475 |
$89K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,483 |
1,310 |
$81K |
| K0001 |
Standard wheelchair |
5,555 |
4,091 |
$76K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,437 |
2,046 |
$66K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,620 |
1,099 |
$37K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,254 |
1,028 |
$37K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
937 |
843 |
$36K |
| A7035 |
Headgear used with positive airway pressure device |
1,880 |
1,577 |
$31K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,621 |
2,076 |
$30K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
300 |
260 |
$29K |
| E0570 |
Nebulizer, with compressor |
1,494 |
1,075 |
$23K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,297 |
2,831 |
$18K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
392 |
324 |
$13K |
| A4927 |
Gloves, non-sterile, per 100 |
1,049 |
769 |
$13K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,298 |
1,112 |
$12K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
827 |
640 |
$10K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,163 |
938 |
$8K |
| 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) |
93 |
75 |
$8K |
| T4541 |
Incontinence product, disposable underpad, large, each |
370 |
330 |
$6K |
| A4670 |
Automatic blood pressure monitor |
91 |
88 |
$4K |
| E1392 |
Portable oxygen concentrator, rental |
296 |
264 |
$4K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
14 |
13 |
$3K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
327 |
284 |
$2K |
| A7000 |
Canister, disposable, used with suction pump, each |
108 |
89 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
104 |
87 |
$2K |
| A7002 |
Tubing, used with suction pump, each |
146 |
125 |
$1K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
15 |
13 |
$1K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
13 |
12 |
$941.46 |
| E0156 |
Seat attachment, walker |
107 |
93 |
$870.87 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
31 |
24 |
$228.07 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
89 |
37 |
$94.76 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
44 |
41 |
$76.04 |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
14 |
12 |
$25.35 |