| 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 |
10,478 |
9,565 |
$973K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,065 |
3,872 |
$221K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,739 |
1,653 |
$215K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,500 |
1,430 |
$173K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,499 |
2,406 |
$167K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,416 |
1,340 |
$160K |
| E0570 |
Nebulizer, with compressor |
3,870 |
3,726 |
$157K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,389 |
1,334 |
$132K |
| 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) |
986 |
948 |
$127K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,681 |
4,415 |
$95K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,534 |
4,090 |
$84K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,691 |
1,608 |
$68K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,689 |
1,634 |
$47K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
574 |
565 |
$39K |
| A7035 |
Headgear used with positive airway pressure device |
1,769 |
1,711 |
$36K |
| E1392 |
Portable oxygen concentrator, rental |
1,730 |
1,633 |
$30K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
148 |
145 |
$29K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
159 |
151 |
$18K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
424 |
403 |
$16K |
| A7031 |
Face mask interface, replacement for full face mask, each |
462 |
441 |
$16K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
523 |
487 |
$13K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,284 |
2,204 |
$12K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
87 |
82 |
$11K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
348 |
340 |
$11K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
858 |
825 |
$9K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,008 |
1,882 |
$7K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
61 |
59 |
$6K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
100 |
91 |
$6K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
53 |
52 |
$5K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
13 |
13 |
$4K |
| K0001 |
Standard wheelchair |
141 |
132 |
$4K |
| A4670 |
Automatic blood pressure monitor |
66 |
65 |
$4K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
15 |
14 |
$2K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
12 |
12 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
696 |
666 |
$967.54 |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
13 |
12 |
$463.14 |
| A7037 |
Tubing used with positive airway pressure device |
16 |
16 |
$369.31 |
| A4927 |
Gloves, non-sterile, per 100 |
12 |
12 |
$175.18 |