| 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 |
34,818 |
32,661 |
$2.30M |
| 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 |
15,356 |
14,423 |
$457K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
642 |
556 |
$418K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,411 |
3,148 |
$232K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,201 |
2,965 |
$143K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
718 |
601 |
$143K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,781 |
4,395 |
$123K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,063 |
3,711 |
$123K |
| E1392 |
Portable oxygen concentrator, rental |
4,752 |
4,351 |
$101K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,553 |
2,279 |
$99K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
469 |
415 |
$65K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,801 |
4,365 |
$65K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
625 |
518 |
$58K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
2,578 |
1,679 |
$55K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,523 |
2,295 |
$54K |
| E0441 |
Stationary oxygen contents, gaseous, 1 month's supply = 1 unit |
967 |
955 |
$50K |
| A7035 |
Headgear used with positive airway pressure device |
3,242 |
2,979 |
$45K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,444 |
3,170 |
$32K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
8,285 |
7,436 |
$31K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
910 |
830 |
$21K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,321 |
1,188 |
$20K |
| E0442 |
Stationary oxygen contents, liquid, 1 month's supply = 1 unit |
433 |
345 |
$17K |
| K0001 |
Standard wheelchair |
1,300 |
1,189 |
$16K |
| A7037 |
Tubing used with positive airway pressure device |
1,060 |
970 |
$15K |
| 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) |
126 |
106 |
$14K |
| E0570 |
Nebulizer, with compressor |
1,443 |
1,305 |
$14K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
815 |
731 |
$14K |
| K0002 |
Standard hemi (low seat) wheelchair |
419 |
389 |
$9K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
168 |
113 |
$9K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
292 |
232 |
$8K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
111 |
99 |
$8K |
| 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) |
28 |
24 |
$7K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,451 |
696 |
$5K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
168 |
141 |
$4K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
27 |
24 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
508 |
431 |
$2K |
| E0156 |
Seat attachment, walker |
313 |
279 |
$2K |
| A7020 |
Interface for cough stimulating device, includes all components, replacement only |
194 |
159 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
24 |
24 |
$1K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
1,084 |
509 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
73 |
71 |
$968.11 |
| K0003 |
Lightweight wheelchair |
30 |
25 |
$612.00 |
| S8189 |
Tracheostomy supply, not otherwise classified |
127 |
94 |
$456.87 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
85 |
80 |
$340.34 |
| A7036 |
Chinstrap used with positive airway pressure device |
28 |
27 |
$219.51 |
| A7002 |
Tubing, used with suction pump, each |
43 |
36 |
$208.99 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
12 |
12 |
$68.37 |