| 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 |
13,599 |
13,572 |
$994K |
| E0601 |
Continuous positive airway pressure (cpap) device |
8,659 |
8,620 |
$658K |
| E0570 |
Nebulizer, with compressor |
8,846 |
8,834 |
$281K |
| K0001 |
Standard wheelchair |
12,069 |
12,057 |
$246K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
8,463 |
8,424 |
$234K |
| 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) |
1,467 |
1,464 |
$224K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
10,251 |
10,223 |
$156K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,239 |
2,091 |
$150K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
2,406 |
2,405 |
$145K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,119 |
3,113 |
$123K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,211 |
3,159 |
$116K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
839 |
836 |
$113K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,221 |
2,157 |
$112K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,680 |
7,487 |
$107K |
| A7035 |
Headgear used with positive airway pressure device |
4,983 |
4,793 |
$107K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,687 |
2,682 |
$87K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
4,736 |
4,734 |
$77K |
| A7037 |
Tubing used with positive airway pressure device |
4,128 |
3,990 |
$65K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,907 |
1,905 |
$63K |
| E0245 |
Tub stool or bench |
1,333 |
1,331 |
$54K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,795 |
1,751 |
$46K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,220 |
1,150 |
$45K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
4,381 |
4,378 |
$44K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
3,631 |
3,622 |
$41K |
| 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 |
1,491 |
1,486 |
$36K |
| K0003 |
Lightweight wheelchair |
1,387 |
1,387 |
$36K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
3,900 |
3,732 |
$28K |
| K0006 |
Heavy duty wheelchair |
434 |
428 |
$25K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
223 |
222 |
$16K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
963 |
961 |
$16K |
| E0271 |
Mattress, innerspring |
648 |
646 |
$16K |
| E0305 |
Bed side rails, half length |
547 |
545 |
$12K |
| E0156 |
Seat attachment, walker |
1,121 |
1,119 |
$11K |
| K0007 |
Extra heavy duty wheelchair |
139 |
139 |
$10K |
| A7015 |
Aerosol mask, used with dme nebulizer |
3,774 |
3,766 |
$5K |
| E0244 |
Raised toilet seat |
102 |
102 |
$4K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
17 |
17 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,278 |
1,267 |
$4K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
130 |
129 |
$3K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
49 |
49 |
$818.82 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
81 |
81 |
$749.51 |
| A7036 |
Chinstrap used with positive airway pressure device |
14 |
14 |
$160.89 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
12 |
12 |
$159.90 |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
12 |
12 |
$133.10 |