| 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 |
10,684 |
10,496 |
$1.04M |
| E0601 |
Continuous positive airway pressure (cpap) device |
7,485 |
7,438 |
$455K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,269 |
2,235 |
$255K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,613 |
8,386 |
$155K |
| E0570 |
Nebulizer, with compressor |
6,510 |
6,439 |
$147K |
| 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) |
1,035 |
1,018 |
$142K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,161 |
2,137 |
$125K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,983 |
1,975 |
$103K |
| K0001 |
Standard wheelchair |
3,234 |
3,207 |
$84K |
| T4541 |
Incontinence product, disposable underpad, large, each |
824 |
802 |
$84K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,163 |
1,152 |
$81K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
530 |
522 |
$77K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,662 |
1,650 |
$73K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
568 |
564 |
$69K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
913 |
902 |
$59K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
412 |
403 |
$53K |
| A7035 |
Headgear used with positive airway pressure device |
2,354 |
2,310 |
$51K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
6,027 |
5,928 |
$51K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
249 |
246 |
$41K |
| A7037 |
Tubing used with positive airway pressure device |
1,811 |
1,785 |
$37K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
200 |
198 |
$37K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
314 |
310 |
$36K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,426 |
1,409 |
$18K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
298 |
298 |
$17K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
2,693 |
2,486 |
$16K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
79 |
64 |
$15K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
303 |
300 |
$11K |
| A4927 |
Gloves, non-sterile, per 100 |
759 |
740 |
$9K |
| K0003 |
Lightweight wheelchair |
133 |
133 |
$7K |
| E1392 |
Portable oxygen concentrator, rental |
165 |
164 |
$6K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
36 |
36 |
$4K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
28 |
27 |
$4K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
216 |
216 |
$3K |
| 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 |
14 |
12 |
$3K |
| B9002 |
Enteral nutrition infusion pump, any type |
27 |
25 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
745 |
745 |
$1K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
25 |
25 |
$1K |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
800 |
793 |
$996.51 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
270 |
269 |
$647.20 |
| A4335 |
Incontinence supply; miscellaneous |
24 |
24 |
$303.36 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
12 |
12 |
$103.90 |