| 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 |
6,420 |
5,788 |
$321K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
267 |
240 |
$128K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,870 |
3,395 |
$52K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
354 |
284 |
$46K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
182 |
169 |
$39K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
323 |
320 |
$30K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,982 |
1,920 |
$26K |
| 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 |
1,272 |
1,163 |
$18K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
630 |
624 |
$13K |
| A7526 |
Tracheostomy tube collar/holder, each |
361 |
288 |
$12K |
| E0570 |
Nebulizer, with compressor |
1,409 |
1,383 |
$12K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
149 |
118 |
$9K |
| A4927 |
Gloves, non-sterile, per 100 |
269 |
238 |
$7K |
| E0601 |
Continuous positive airway pressure (cpap) device |
219 |
206 |
$6K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
107 |
84 |
$6K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
409 |
395 |
$6K |
| K0001 |
Standard wheelchair |
277 |
248 |
$6K |
| A7030 |
Full face mask used with positive airway pressure device, each |
94 |
81 |
$5K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
434 |
377 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
424 |
374 |
$4K |
| A7000 |
Canister, disposable, used with suction pump, each |
655 |
584 |
$4K |
| A4217 |
Sterile water/saline, 500 ml |
106 |
96 |
$2K |
| A7031 |
Face mask interface, replacement for full face mask, each |
78 |
70 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
404 |
353 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
260 |
243 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
83 |
74 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
489 |
458 |
$1K |
| A7002 |
Tubing, used with suction pump, each |
466 |
436 |
$1K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
52 |
51 |
$1K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
77 |
70 |
$904.16 |
| A7035 |
Headgear used with positive airway pressure device |
42 |
41 |
$666.62 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
28 |
27 |
$622.78 |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
111 |
103 |
$592.44 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
70 |
66 |
$427.42 |
| A7012 |
Water collection device, used with large volume nebulizer |
65 |
62 |
$351.99 |
| A7525 |
Tracheostomy mask, each |
199 |
173 |
$297.22 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
73 |
65 |
$269.81 |
| A7015 |
Aerosol mask, used with dme nebulizer |
169 |
158 |
$188.28 |
| A7037 |
Tubing used with positive airway pressure device |
12 |
12 |
$162.45 |