| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,165 |
1,927 |
$760K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
13,027 |
12,077 |
$709K |
| E0601 |
Continuous positive airway pressure (cpap) device |
14,301 |
13,792 |
$688K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,424 |
1,257 |
$642K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,559 |
3,259 |
$323K |
| 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) |
2,719 |
2,527 |
$321K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,690 |
3,415 |
$241K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,445 |
3,188 |
$147K |
| K0001 |
Standard wheelchair |
5,187 |
4,928 |
$136K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,885 |
3,678 |
$130K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,392 |
5,062 |
$128K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
611 |
574 |
$115K |
| A7035 |
Headgear used with positive airway pressure device |
5,581 |
5,261 |
$108K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,048 |
2,811 |
$69K |
| A7037 |
Tubing used with positive airway pressure device |
3,800 |
3,628 |
$65K |
| A4623 |
Tracheostomy, inner cannula |
851 |
771 |
$53K |
| K0003 |
Lightweight wheelchair |
835 |
773 |
$49K |
| E1392 |
Portable oxygen concentrator, rental |
2,790 |
2,560 |
$40K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
813 |
752 |
$40K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,337 |
1,138 |
$35K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
947 |
899 |
$30K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
479 |
442 |
$27K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
8,769 |
7,363 |
$25K |
| A7526 |
Tracheostomy tube collar/holder, each |
974 |
867 |
$21K |
| E0570 |
Nebulizer, with compressor |
1,104 |
990 |
$20K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
696 |
608 |
$18K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
700 |
612 |
$17K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
457 |
442 |
$16K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
257 |
238 |
$13K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
101 |
96 |
$13K |
| K0006 |
Heavy duty wheelchair |
145 |
139 |
$13K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,168 |
1,069 |
$12K |
| E0245 |
Tub stool or bench |
340 |
321 |
$11K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,094 |
992 |
$8K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
200 |
168 |
$7K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
489 |
435 |
$6K |
| K0053 |
Elevating footrests, articulating (telescoping), each |
186 |
159 |
$4K |
| A7002 |
Tubing, used with suction pump, each |
1,019 |
905 |
$4K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
88 |
86 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
961 |
880 |
$3K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
88 |
85 |
$2K |
| A4930 |
Gloves, sterile, per pair |
62 |
50 |
$2K |
| A4605 |
Tracheal suction catheter, closed system, each |
159 |
142 |
$2K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
65 |
50 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
250 |
230 |
$2K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
80 |
72 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
129 |
104 |
$1K |
| 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 |
28 |
13 |
$980.80 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
28 |
26 |
$929.70 |
| A4670 |
Automatic blood pressure monitor |
26 |
26 |
$878.90 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
79 |
71 |
$829.28 |
| E0156 |
Seat attachment, walker |
104 |
100 |
$726.34 |
| A7012 |
Water collection device, used with large volume nebulizer |
377 |
318 |
$686.15 |
| 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 |
26 |
12 |
$582.06 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
169 |
153 |
$567.81 |
| E0244 |
Raised toilet seat |
12 |
12 |
$456.09 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
27 |
25 |
$444.25 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
196 |
169 |
$319.65 |
| A7525 |
Tracheostomy mask, each |
191 |
179 |
$225.77 |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
20 |
12 |
$224.37 |
| A7036 |
Chinstrap used with positive airway pressure device |
29 |
24 |
$224.09 |
| A4244 |
Alcohol or peroxide, per pint |
25 |
25 |
$20.72 |