| Code | Description | Claims | Beneficiaries | Total Paid |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
669 |
358 |
$326K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,132 |
1,861 |
$173K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,116 |
954 |
$48K |
| E0601 |
Continuous positive airway pressure (cpap) device |
933 |
809 |
$44K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
330 |
302 |
$33K |
| A7030 |
Full face mask used with positive airway pressure device, each |
470 |
433 |
$32K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
151 |
146 |
$24K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
361 |
328 |
$22K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
512 |
481 |
$20K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
935 |
809 |
$17K |
| A7526 |
Tracheostomy tube collar/holder, each |
426 |
346 |
$13K |
| A7035 |
Headgear used with positive airway pressure device |
771 |
714 |
$12K |
| A4217 |
Sterile water/saline, 500 ml |
403 |
332 |
$12K |
| A7031 |
Face mask interface, replacement for full face mask, each |
392 |
372 |
$11K |
| E0570 |
Nebulizer, with compressor |
997 |
946 |
$11K |
| A7037 |
Tubing used with positive airway pressure device |
872 |
802 |
$10K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
739 |
696 |
$10K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
71 |
58 |
$8K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
468 |
404 |
$7K |
| A4618 |
Breathing circuits |
332 |
300 |
$6K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
186 |
139 |
$6K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
140 |
136 |
$6K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
155 |
147 |
$4K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
241 |
227 |
$4K |
| 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 |
534 |
512 |
$3K |
| K0001 |
Standard wheelchair |
368 |
318 |
$3K |
| A7000 |
Canister, disposable, used with suction pump, each |
447 |
429 |
$3K |
| A4927 |
Gloves, non-sterile, per 100 |
343 |
302 |
$3K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
281 |
258 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
890 |
821 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
470 |
438 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
459 |
433 |
$1K |
| A7002 |
Tubing, used with suction pump, each |
154 |
140 |
$1K |
| A4456 |
Adhesive remover, wipes, any type, each |
226 |
165 |
$1K |
| A5120 |
Skin barrier, wipes or swabs, each |
280 |
209 |
$974.51 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
76 |
61 |
$581.64 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
26 |
25 |
$334.38 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
12 |
12 |
$244.75 |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
16 |
15 |
$156.50 |
| A4452 |
Tape, waterproof, per 18 square inches |
16 |
14 |
$73.36 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
14 |
14 |
$32.59 |
| A4626 |
Tracheostomy cleaning brush, each |
182 |
174 |
$20.82 |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
17 |
14 |
$0.00 |