| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
3,123 |
2,907 |
$451K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,808 |
3,616 |
$431K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,184 |
2,900 |
$303K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
6,195 |
5,506 |
$299K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,718 |
2,566 |
$186K |
| A7037 |
Tubing used with positive airway pressure device |
5,804 |
5,510 |
$146K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,683 |
3,251 |
$144K |
| A7035 |
Headgear used with positive airway pressure device |
5,614 |
5,328 |
$144K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,528 |
2,361 |
$88K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,096 |
2,692 |
$54K |
| E0570 |
Nebulizer, with compressor |
3,079 |
2,764 |
$44K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
6,069 |
5,730 |
$34K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,846 |
3,664 |
$32K |
| E1392 |
Portable oxygen concentrator, rental |
1,632 |
1,473 |
$26K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
3,646 |
3,480 |
$25K |
| K0001 |
Standard wheelchair |
2,245 |
1,800 |
$20K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,237 |
1,164 |
$16K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
986 |
917 |
$13K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
626 |
482 |
$8K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
191 |
171 |
$5K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
256 |
231 |
$4K |
| A5120 |
Skin barrier, wipes or swabs, each |
159 |
150 |
$814.35 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
119 |
116 |
$776.43 |
| A4456 |
Adhesive remover, wipes, any type, each |
130 |
120 |
$712.92 |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
30 |
24 |
$453.30 |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
25 |
24 |
$404.40 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
16 |
15 |
$316.95 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
544 |
427 |
$278.67 |
| A7015 |
Aerosol mask, used with dme nebulizer |
154 |
146 |
$176.04 |
| E0156 |
Seat attachment, walker |
30 |
26 |
$115.38 |
| A7000 |
Canister, disposable, used with suction pump, each |
13 |
12 |
$70.45 |
| A7002 |
Tubing, used with suction pump, each |
13 |
12 |
$48.02 |
| E0604 |
Breast pump, hospital grade, electric (ac and / or dc), any type |
17 |
12 |
$0.00 |