| 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 |
8,695 |
8,266 |
$360K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,141 |
2,092 |
$80K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,235 |
6,925 |
$55K |
| A7030 |
Full face mask used with positive airway pressure device, each |
777 |
770 |
$46K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,174 |
1,143 |
$35K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
672 |
659 |
$28K |
| 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) |
361 |
348 |
$20K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
790 |
729 |
$19K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
69 |
63 |
$18K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
128 |
126 |
$16K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
329 |
321 |
$15K |
| K0001 |
Standard wheelchair |
1,293 |
1,212 |
$12K |
| A7035 |
Headgear used with positive airway pressure device |
889 |
867 |
$11K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
301 |
279 |
$9K |
| A7037 |
Tubing used with positive airway pressure device |
989 |
982 |
$9K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
239 |
239 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,151 |
2,097 |
$6K |
| E0570 |
Nebulizer, with compressor |
402 |
395 |
$6K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
186 |
179 |
$5K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
689 |
657 |
$4K |
| E1392 |
Portable oxygen concentrator, rental |
370 |
359 |
$4K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
53 |
52 |
$2K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
26 |
26 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
261 |
257 |
$2K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
53 |
53 |
$777.60 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
81 |
78 |
$494.39 |
| B9002 |
Enteral nutrition infusion pump, any type |
17 |
17 |
$133.73 |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
208 |
205 |
$85.40 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
26 |
25 |
$36.97 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
28 |
28 |
$19.26 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
34 |
34 |
$0.00 |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
13 |
13 |
$0.00 |
| K0003 |
Lightweight wheelchair |
15 |
15 |
$0.00 |
| A4615 |
Cannula, nasal |
18 |
15 |
$0.00 |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
17 |
12 |
$0.00 |