| 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 |
9,185 |
8,026 |
$415K |
| E0570 |
Nebulizer, with compressor |
24,203 |
21,633 |
$265K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,687 |
2,314 |
$140K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,867 |
4,336 |
$136K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
3,306 |
2,836 |
$99K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
4,962 |
4,369 |
$95K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,082 |
6,207 |
$65K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,477 |
1,287 |
$47K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
496 |
366 |
$41K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
751 |
580 |
$40K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,251 |
1,907 |
$39K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,268 |
1,116 |
$35K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
672 |
617 |
$33K |
| K0001 |
Standard wheelchair |
3,658 |
3,293 |
$29K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
628 |
511 |
$28K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
275 |
247 |
$27K |
| A7037 |
Tubing used with positive airway pressure device |
1,763 |
1,557 |
$25K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
184 |
164 |
$24K |
| A7035 |
Headgear used with positive airway pressure device |
2,646 |
2,278 |
$23K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,294 |
1,965 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,309 |
3,695 |
$20K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
156 |
132 |
$19K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
128 |
107 |
$14K |
| 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) |
316 |
256 |
$13K |
| A4259 |
Lancets, per box of 100 |
4,172 |
3,680 |
$13K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
372 |
320 |
$12K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
124 |
113 |
$12K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
149 |
149 |
$10K |
| A4554 |
Disposable underpads, all sizes |
287 |
232 |
$8K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,473 |
1,257 |
$7K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
332 |
270 |
$7K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
45 |
41 |
$7K |
| B9002 |
Enteral nutrition infusion pump, any type |
107 |
107 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
728 |
422 |
$5K |
| A4335 |
Incontinence supply; miscellaneous |
717 |
418 |
$4K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
138 |
114 |
$3K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
19 |
13 |
$2K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
56 |
52 |
$2K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
17 |
12 |
$2K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
23 |
12 |
$2K |
| A4245 |
Alcohol wipes, per box |
710 |
625 |
$1K |
| E0156 |
Seat attachment, walker |
174 |
151 |
$995.60 |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
14 |
12 |
$759.20 |
| S8490 |
Insulin syringes (100 syringes, any size) |
27 |
25 |
$479.70 |
| E1392 |
Portable oxygen concentrator, rental |
12 |
12 |
$132.39 |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
13 |
12 |
$35.03 |
| A4256 |
Normal, low and high calibrator solution / chips |
26 |
22 |
$17.64 |