| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
861 |
510 |
$236K |
| E0601 |
Continuous positive airway pressure (cpap) device |
9,120 |
5,774 |
$222K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,484 |
4,144 |
$191K |
| A4554 |
Disposable underpads, all sizes |
2,380 |
2,044 |
$115K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,442 |
1,157 |
$105K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,187 |
977 |
$100K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,247 |
942 |
$99K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
810 |
633 |
$52K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,416 |
1,182 |
$45K |
| A4927 |
Gloves, non-sterile, per 100 |
2,529 |
2,129 |
$39K |
| E0430 |
Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing |
768 |
472 |
$28K |
| E0570 |
Nebulizer, with compressor |
1,790 |
1,500 |
$19K |
| 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) |
263 |
183 |
$18K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
130 |
82 |
$14K |
| K0003 |
Lightweight wheelchair |
1,522 |
1,390 |
$12K |
| E1392 |
Portable oxygen concentrator, rental |
750 |
692 |
$11K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,327 |
1,120 |
$10K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
962 |
795 |
$9K |
| A7030 |
Full face mask used with positive airway pressure device, each |
521 |
443 |
$9K |
| A7031 |
Face mask interface, replacement for full face mask, each |
523 |
446 |
$7K |
| K0001 |
Standard wheelchair |
1,134 |
1,030 |
$6K |
| E0277 |
Powered pressure-reducing air mattress |
56 |
48 |
$3K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
402 |
330 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
207 |
193 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
516 |
432 |
$943.68 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
17 |
14 |
$700.76 |
| A7037 |
Tubing used with positive airway pressure device |
173 |
137 |
$576.01 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
47 |
39 |
$400.52 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
20 |
13 |
$362.75 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
92 |
83 |
$295.58 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
85 |
66 |
$137.64 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
38 |
33 |
$18.81 |