| 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 |
14,707 |
14,578 |
$1.01M |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
5,107 |
5,072 |
$254K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,392 |
1,392 |
$233K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,353 |
11,265 |
$161K |
| K0001 |
Standard wheelchair |
6,489 |
6,359 |
$119K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
2,262 |
2,203 |
$111K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
685 |
638 |
$77K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,464 |
1,453 |
$76K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
2,132 |
2,092 |
$75K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,573 |
1,566 |
$63K |
| E1392 |
Portable oxygen concentrator, rental |
1,886 |
1,874 |
$63K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
832 |
824 |
$57K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
565 |
532 |
$55K |
| E0570 |
Nebulizer, with compressor |
4,361 |
4,334 |
$55K |
| A7030 |
Full face mask used with positive airway pressure device, each |
850 |
848 |
$52K |
| 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) |
560 |
557 |
$48K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
570 |
568 |
$37K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
312 |
301 |
$32K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
884 |
879 |
$29K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,681 |
2,655 |
$28K |
| A7031 |
Face mask interface, replacement for full face mask, each |
985 |
962 |
$27K |
| A4670 |
Automatic blood pressure monitor |
432 |
427 |
$21K |
| K0003 |
Lightweight wheelchair |
693 |
689 |
$18K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
1,548 |
1,476 |
$18K |
| A4554 |
Disposable underpads, all sizes |
262 |
255 |
$17K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
631 |
631 |
$17K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
276 |
276 |
$15K |
| A4217 |
Sterile water/saline, 500 ml |
1,088 |
963 |
$15K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,233 |
1,156 |
$14K |
| A7526 |
Tracheostomy tube collar/holder, each |
292 |
277 |
$14K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
555 |
551 |
$13K |
| A7035 |
Headgear used with positive airway pressure device |
1,148 |
1,146 |
$13K |
| E0156 |
Seat attachment, walker |
871 |
865 |
$9K |
| A4623 |
Tracheostomy, inner cannula |
232 |
217 |
$9K |
| A7037 |
Tubing used with positive airway pressure device |
859 |
856 |
$9K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
444 |
439 |
$8K |
| E0245 |
Tub stool or bench |
257 |
256 |
$7K |
| E0244 |
Raised toilet seat |
376 |
373 |
$7K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
13 |
13 |
$6K |
| A4605 |
Tracheal suction catheter, closed system, each |
202 |
177 |
$6K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
214 |
191 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,420 |
2,372 |
$6K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
148 |
141 |
$5K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,044 |
951 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,211 |
1,198 |
$4K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
584 |
515 |
$3K |
| A7002 |
Tubing, used with suction pump, each |
1,175 |
1,088 |
$3K |
| E0271 |
Mattress, innerspring |
80 |
79 |
$3K |
| E0277 |
Powered pressure-reducing air mattress |
12 |
12 |
$3K |
| A4927 |
Gloves, non-sterile, per 100 |
656 |
627 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
426 |
426 |
$2K |
| K0007 |
Extra heavy duty wheelchair |
24 |
24 |
$2K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
12 |
12 |
$2K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
255 |
240 |
$2K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
170 |
170 |
$2K |
| K0006 |
Heavy duty wheelchair |
96 |
96 |
$2K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
223 |
221 |
$1K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
80 |
80 |
$1K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
50 |
50 |
$1K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
12 |
12 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
366 |
350 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
378 |
371 |
$1K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
44 |
43 |
$909.13 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
77 |
77 |
$874.82 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
47 |
38 |
$761.09 |
| E0305 |
Bed side rails, half length |
112 |
111 |
$754.09 |
| E0246 |
Transfer tub rail attachment |
15 |
15 |
$665.70 |
| B9002 |
Enteral nutrition infusion pump, any type |
12 |
12 |
$575.10 |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
12 |
12 |
$573.65 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
149 |
149 |
$518.54 |
| A7525 |
Tracheostomy mask, each |
156 |
148 |
$367.20 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
12 |
12 |
$134.71 |
| A7015 |
Aerosol mask, used with dme nebulizer |
39 |
39 |
$22.26 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
93 |
92 |
$17.14 |