| 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 |
10,350 |
9,343 |
$1.13M |
| E0601 |
Continuous positive airway pressure (cpap) device |
14,356 |
13,279 |
$848K |
| E0570 |
Nebulizer, with compressor |
6,133 |
5,659 |
$314K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
14,335 |
13,303 |
$306K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,291 |
2,155 |
$250K |
| 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 |
5,624 |
5,097 |
$193K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,764 |
2,621 |
$189K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,003 |
1,888 |
$155K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,229 |
3,995 |
$153K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,139 |
1,099 |
$129K |
| K0001 |
Standard wheelchair |
4,193 |
3,925 |
$121K |
| A4670 |
Automatic blood pressure monitor |
1,922 |
1,850 |
$121K |
| A7035 |
Headgear used with positive airway pressure device |
4,380 |
4,136 |
$108K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,058 |
1,928 |
$99K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,472 |
1,372 |
$81K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,254 |
1,180 |
$74K |
| L0970 |
Tlso, corset front |
726 |
695 |
$51K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,317 |
1,222 |
$47K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,638 |
5,262 |
$35K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,588 |
2,410 |
$34K |
| A7031 |
Face mask interface, replacement for full face mask, each |
914 |
848 |
$33K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
1,213 |
1,113 |
$32K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
616 |
567 |
$29K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
344 |
334 |
$23K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
157 |
153 |
$21K |
| K0003 |
Lightweight wheelchair |
350 |
326 |
$20K |
| E1392 |
Portable oxygen concentrator, rental |
1,049 |
966 |
$19K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
174 |
166 |
$18K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
685 |
638 |
$15K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
314 |
291 |
$14K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
385 |
379 |
$13K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
101 |
90 |
$12K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
74 |
68 |
$9K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
150 |
149 |
$9K |
| A4927 |
Gloves, non-sterile, per 100 |
650 |
606 |
$8K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
134 |
128 |
$6K |
| E0245 |
Tub stool or bench |
132 |
131 |
$5K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
721 |
687 |
$5K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
31 |
25 |
$5K |
| A4452 |
Tape, waterproof, per 18 square inches |
363 |
313 |
$5K |
| A7036 |
Chinstrap used with positive airway pressure device |
475 |
437 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,697 |
1,579 |
$4K |
| E0156 |
Seat attachment, walker |
383 |
355 |
$4K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
26 |
25 |
$3K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
29 |
26 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
108 |
101 |
$2K |
| 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) |
13 |
13 |
$2K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
53 |
48 |
$2K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
25 |
24 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
90 |
90 |
$2K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
315 |
290 |
$1K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
12 |
12 |
$989.67 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
340 |
331 |
$859.56 |
| A7015 |
Aerosol mask, used with dme nebulizer |
376 |
357 |
$526.10 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
17 |
12 |
$267.06 |
| A4565 |
Slings |
12 |
12 |
$76.45 |