| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
3,621 |
3,333 |
$610K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
9,142 |
7,413 |
$455K |
| E0601 |
Continuous positive airway pressure (cpap) device |
7,636 |
6,764 |
$436K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,648 |
3,083 |
$302K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
4,721 |
4,171 |
$263K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
7,350 |
6,342 |
$224K |
| 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) |
1,370 |
1,240 |
$204K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
5,680 |
4,359 |
$164K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,642 |
3,080 |
$156K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
3,163 |
2,809 |
$139K |
| E0570 |
Nebulizer, with compressor |
5,168 |
3,936 |
$133K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,157 |
1,945 |
$126K |
| K0001 |
Standard wheelchair |
7,949 |
6,015 |
$116K |
| A7035 |
Headgear used with positive airway pressure device |
5,140 |
4,455 |
$93K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,652 |
2,047 |
$92K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
9,665 |
8,416 |
$62K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
2,191 |
1,883 |
$57K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,087 |
4,840 |
$54K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
556 |
495 |
$42K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
479 |
436 |
$32K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,419 |
2,952 |
$30K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
2,044 |
1,627 |
$29K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,113 |
811 |
$29K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,437 |
1,206 |
$25K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
250 |
229 |
$22K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,110 |
999 |
$20K |
| E1392 |
Portable oxygen concentrator, rental |
1,098 |
960 |
$16K |
| K0007 |
Extra heavy duty wheelchair |
257 |
192 |
$16K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,105 |
1,685 |
$15K |
| A4927 |
Gloves, non-sterile, per 100 |
1,265 |
957 |
$13K |
| E0156 |
Seat attachment, walker |
1,633 |
1,295 |
$13K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
122 |
116 |
$10K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
38 |
28 |
$6K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
27 |
26 |
$3K |
| E0277 |
Powered pressure-reducing air mattress |
19 |
12 |
$2K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
15 |
13 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
57 |
51 |
$1K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
18 |
12 |
$832.26 |
| A7036 |
Chinstrap used with positive airway pressure device |
95 |
87 |
$770.82 |
| E0240 |
Bath/shower chair, with or without wheels, any size |
15 |
13 |
$749.45 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
21 |
14 |
$475.70 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
113 |
101 |
$235.34 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
27 |
26 |
$170.43 |
| A7000 |
Canister, disposable, used with suction pump, each |
13 |
12 |
$143.47 |
| A7015 |
Aerosol mask, used with dme nebulizer |
90 |
85 |
$121.39 |
| A7002 |
Tubing, used with suction pump, each |
16 |
12 |
$71.50 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
43 |
31 |
$0.00 |