| 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 |
59,696 |
52,450 |
$4.05M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
46,992 |
41,421 |
$1.18M |
| E0601 |
Continuous positive airway pressure (cpap) device |
13,609 |
12,193 |
$736K |
| S9500 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
1,407 |
457 |
$642K |
| K0001 |
Standard wheelchair |
12,701 |
10,754 |
$442K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
2,195 |
2,097 |
$381K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
7,509 |
6,253 |
$367K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,670 |
4,052 |
$235K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
4,818 |
4,556 |
$189K |
| 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) |
1,204 |
1,052 |
$148K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,962 |
2,710 |
$137K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,673 |
3,364 |
$133K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,658 |
1,500 |
$127K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
6,537 |
5,167 |
$108K |
| E0570 |
Nebulizer, with compressor |
5,936 |
5,419 |
$107K |
| A7035 |
Headgear used with positive airway pressure device |
4,423 |
4,026 |
$105K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
1,696 |
1,504 |
$98K |
| K0003 |
Lightweight wheelchair |
1,650 |
1,330 |
$97K |
| K0007 |
Extra heavy duty wheelchair |
585 |
520 |
$73K |
| K0006 |
Heavy duty wheelchair |
959 |
827 |
$72K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,578 |
1,411 |
$57K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
524 |
350 |
$56K |
| E0245 |
Tub stool or bench |
1,449 |
1,297 |
$53K |
| V5160 |
Dispensing fee, binaural |
233 |
172 |
$49K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
2,442 |
1,091 |
$40K |
| 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 |
612 |
577 |
$37K |
| S9340 |
Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
45 |
37 |
$37K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
9,752 |
8,874 |
$36K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
240 |
222 |
$31K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
189 |
81 |
$30K |
| E1392 |
Portable oxygen concentrator, rental |
1,566 |
1,433 |
$26K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
1,193 |
1,118 |
$25K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,779 |
1,633 |
$23K |
| V5261 |
Hearing aid, digital, binaural, bte |
18 |
13 |
$20K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
317 |
125 |
$20K |
| K0002 |
Standard hemi (low seat) wheelchair |
294 |
215 |
$19K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
4,505 |
2,082 |
$17K |
| J0878 |
Injection, daptomycin, 1 mg |
190 |
13 |
$17K |
| E0244 |
Raised toilet seat |
443 |
402 |
$14K |
| K0052 |
Swingaway, detachable footrests, replacement only, each |
1,786 |
1,642 |
$11K |
| A7037 |
Tubing used with positive airway pressure device |
404 |
360 |
$9K |
| E0156 |
Seat attachment, walker |
806 |
757 |
$8K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,611 |
1,469 |
$7K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
584 |
536 |
$6K |
| L1810 |
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
108 |
91 |
$6K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 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 |
26 |
25 |
$5K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
75 |
63 |
$3K |
| A7031 |
Face mask interface, replacement for full face mask, each |
77 |
73 |
$3K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
62 |
50 |
$2K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
94 |
25 |
$2K |
| E0184 |
Dry pressure mattress |
78 |
69 |
$2K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
40 |
13 |
$1K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
174 |
160 |
$1K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
190 |
110 |
$1K |
| E0776 |
Iv pole |
30 |
25 |
$1K |
| L8000 |
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type |
47 |
38 |
$1K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
30 |
24 |
$763.12 |
| E0305 |
Bed side rails, half length |
80 |
72 |
$712.35 |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
16 |
13 |
$538.68 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
1,133 |
1,030 |
$505.01 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
13 |
13 |
$211.51 |
| A4565 |
Slings |
12 |
12 |
$69.30 |