| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,423 |
1,422 |
$1.38M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
6,055 |
5,996 |
$537K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
8,320 |
7,859 |
$436K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,063 |
2,945 |
$291K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,667 |
1,648 |
$278K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,700 |
2,559 |
$228K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,968 |
1,883 |
$205K |
| T4541 |
Incontinence product, disposable underpad, large, each |
5,036 |
4,824 |
$197K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
1,469 |
1,465 |
$128K |
| A4623 |
Tracheostomy, inner cannula |
1,769 |
1,768 |
$125K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
522 |
491 |
$96K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,695 |
1,689 |
$80K |
| A4605 |
Tracheal suction catheter, closed system, each |
1,638 |
1,638 |
$78K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,830 |
4,807 |
$75K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
486 |
464 |
$71K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,798 |
1,795 |
$49K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,722 |
1,721 |
$47K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
300 |
296 |
$28K |
| K0001 |
Standard wheelchair |
829 |
826 |
$22K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
597 |
590 |
$20K |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
32 |
20 |
$19K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
884 |
877 |
$18K |
| E0570 |
Nebulizer, with compressor |
886 |
860 |
$18K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
237 |
228 |
$18K |
| A4927 |
Gloves, non-sterile, per 100 |
801 |
767 |
$15K |
| A7002 |
Tubing, used with suction pump, each |
1,801 |
1,774 |
$10K |
| K0003 |
Lightweight wheelchair |
1,031 |
1,019 |
$8K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
421 |
420 |
$7K |
| A7012 |
Water collection device, used with large volume nebulizer |
418 |
418 |
$6K |
| A7008 |
Large volume nebulizer, disposable, prefilled, used with aerosol compressor |
108 |
106 |
$5K |
| A4335 |
Incontinence supply; miscellaneous |
274 |
271 |
$5K |
| A7525 |
Tracheostomy mask, each |
484 |
484 |
$3K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
230 |
210 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
41 |
41 |
$2K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
35 |
33 |
$1K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
92 |
81 |
$1K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
168 |
149 |
$792.99 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
17 |
17 |
$61.49 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
15 |
15 |
$16.05 |