| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer, with compressor |
11,673 |
11,495 |
$921K |
| E0601 |
Continuous positive airway pressure (cpap) device |
6,512 |
5,289 |
$258K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,364 |
3,303 |
$239K |
| E1235 |
Wheelchair, pediatric size, rigid, adjustable, with seating system |
1,006 |
857 |
$174K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
11,058 |
10,879 |
$171K |
| S8101 |
Holding chamber or spacer for use with an inhaler or nebulizer; with mask |
6,959 |
6,870 |
$142K |
| E1150 |
Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests |
2,788 |
2,719 |
$138K |
| 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) |
966 |
961 |
$111K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,630 |
1,597 |
$104K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,975 |
2,918 |
$89K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,698 |
2,616 |
$82K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
3,177 |
3,116 |
$81K |
| K0001 |
Standard wheelchair |
5,547 |
5,358 |
$77K |
| A4554 |
Disposable underpads, all sizes |
2,250 |
2,182 |
$74K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
286 |
269 |
$74K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,255 |
786 |
$61K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,950 |
1,846 |
$61K |
| K0007 |
Extra heavy duty wheelchair |
667 |
645 |
$59K |
| E1399 |
Durable medical equipment, miscellaneous |
705 |
272 |
$47K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,561 |
1,127 |
$43K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
931 |
895 |
$42K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,187 |
768 |
$40K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,645 |
2,574 |
$35K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
459 |
409 |
$35K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,002 |
958 |
$33K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
275 |
234 |
$32K |
| B9998 |
Noc for enteral supplies |
485 |
298 |
$31K |
| A7037 |
Tubing used with positive airway pressure device |
1,769 |
1,638 |
$31K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
951 |
943 |
$26K |
| A7035 |
Headgear used with positive airway pressure device |
2,277 |
2,221 |
$26K |
| K0004 |
High strength, lightweight wheelchair |
921 |
906 |
$25K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
335 |
294 |
$23K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
332 |
320 |
$23K |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
9,421 |
9,278 |
$22K |
| K0003 |
Lightweight wheelchair |
1,409 |
1,388 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,707 |
4,480 |
$18K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
640 |
563 |
$16K |
| A7015 |
Aerosol mask, used with dme nebulizer |
13,087 |
12,845 |
$14K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
849 |
761 |
$13K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
22 |
12 |
$13K |
| A7000 |
Canister, disposable, used with suction pump, each |
603 |
464 |
$13K |
| A4335 |
Incontinence supply; miscellaneous |
2,543 |
2,472 |
$13K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
101 |
100 |
$12K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
956 |
271 |
$12K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
605 |
549 |
$11K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
538 |
527 |
$10K |
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
230 |
229 |
$9K |
| E1089 |
High strength lightweight wheelchair, fixed length arms, swing away detachable footrest |
70 |
68 |
$9K |
| S0215 |
Non-emergency transportation; mileage, per mile |
130 |
47 |
$8K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,250 |
2,023 |
$8K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
96 |
90 |
$7K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
355 |
238 |
$7K |
| K0015 |
Detachable, non-adjustable height armrest, replacement only, each |
159 |
115 |
$7K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
213 |
181 |
$7K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,816 |
1,778 |
$6K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
109 |
74 |
$6K |
| A7526 |
Tracheostomy tube collar/holder, each |
154 |
133 |
$5K |
| A4614 |
Peak expiratory flow rate meter, hand held |
324 |
315 |
$5K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
230 |
228 |
$5K |
| A7002 |
Tubing, used with suction pump, each |
497 |
468 |
$5K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
720 |
692 |
$4K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
29 |
25 |
$4K |
| A4322 |
Irrigation syringe, bulb or piston, each |
1,086 |
267 |
$3K |
| K0006 |
Heavy duty wheelchair |
111 |
108 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,501 |
1,459 |
$3K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
76 |
76 |
$3K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,667 |
1,647 |
$3K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
157 |
134 |
$3K |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
67 |
56 |
$2K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
382 |
246 |
$2K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
473 |
446 |
$2K |
| A0100 |
Non-emergency transportation; taxi |
131 |
47 |
$2K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
14 |
13 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
305 |
291 |
$2K |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
324 |
305 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
365 |
342 |
$2K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
27 |
24 |
$1K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
254 |
210 |
$1K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
192 |
188 |
$1K |
| A4259 |
Lancets, per box of 100 |
149 |
147 |
$1K |
| S8186 |
Swivel adapter |
914 |
878 |
$1K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
28 |
24 |
$1K |
| E1295 |
Heavy duty wheelchair, fixed full length arms, elevating legrest |
12 |
12 |
$913.14 |
| A4618 |
Breathing circuits |
170 |
116 |
$875.81 |
| A4245 |
Alcohol wipes, per box |
495 |
481 |
$724.60 |
| A4332 |
Lubricant, individual sterile packet, each |
256 |
239 |
$628.41 |
| K0052 |
Swingaway, detachable footrests, replacement only, each |
14 |
13 |
$614.50 |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
57 |
38 |
$607.74 |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
13 |
12 |
$519.38 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
12 |
12 |
$259.83 |
| E0167 |
Pail or pan for use with commode chair, replacement only |
74 |
72 |
$98.88 |
| E0155 |
Wheel attachment, rigid pick-up walker, per pair |
31 |
30 |
$32.48 |
| A4657 |
Syringe, with or without needle, each |
23 |
12 |
$30.10 |
| E0156 |
Seat attachment, walker |
15 |
14 |
$0.00 |
| E0159 |
Brake attachment for wheeled walker, replacement, each |
17 |
16 |
$0.00 |