| 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 |
47,816 |
43,259 |
$1.78M |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
3,724 |
3,136 |
$1.77M |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
7,950 |
5,865 |
$973K |
| A7526 |
Tracheostomy tube collar/holder, each |
8,756 |
6,712 |
$481K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
6,518 |
4,960 |
$440K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
6,870 |
5,087 |
$420K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,185 |
1,562 |
$360K |
| K0001 |
Standard wheelchair |
26,833 |
24,369 |
$338K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
40,330 |
36,774 |
$331K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
10,385 |
9,253 |
$320K |
| E0601 |
Continuous positive airway pressure (cpap) device |
10,572 |
9,689 |
$244K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,829 |
1,513 |
$195K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
34,376 |
31,237 |
$181K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
2,358 |
2,127 |
$175K |
| A7030 |
Full face mask used with positive airway pressure device, each |
4,065 |
3,606 |
$165K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
6,935 |
6,136 |
$147K |
| K0006 |
Heavy duty wheelchair |
4,725 |
4,248 |
$141K |
| S8189 |
Tracheostomy supply, not otherwise classified |
546 |
385 |
$134K |
| E0570 |
Nebulizer, with compressor |
18,307 |
16,290 |
$134K |
| A4623 |
Tracheostomy, inner cannula |
2,288 |
1,690 |
$131K |
| E0619 |
Apnea monitor, with recording feature |
691 |
629 |
$123K |
| A7000 |
Canister, disposable, used with suction pump, each |
10,950 |
8,026 |
$109K |
| B4100 |
Food thickener, administered orally, per ounce |
1,466 |
1,265 |
$99K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
4,636 |
3,386 |
$97K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,603 |
3,214 |
$96K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
4,277 |
3,841 |
$96K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
5,291 |
4,828 |
$93K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
8,359 |
7,641 |
$81K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
3,991 |
2,771 |
$79K |
| E2402 |
Negative pressure wound therapy electrical pump, stationary or portable |
300 |
240 |
$77K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,045 |
1,649 |
$77K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
3,740 |
3,241 |
$73K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
707 |
614 |
$62K |
| A7037 |
Tubing used with positive airway pressure device |
7,438 |
6,518 |
$56K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
2,365 |
1,680 |
$55K |
| A7002 |
Tubing, used with suction pump, each |
10,583 |
7,505 |
$55K |
| E0277 |
Powered pressure-reducing air mattress |
874 |
781 |
$54K |
| E1392 |
Portable oxygen concentrator, rental |
5,803 |
5,278 |
$52K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
499 |
394 |
$52K |
| A7035 |
Headgear used with positive airway pressure device |
5,282 |
4,667 |
$49K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
5,752 |
5,317 |
$48K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,857 |
2,534 |
$48K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,730 |
2,383 |
$43K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
1,903 |
1,592 |
$40K |
| A4927 |
Gloves, non-sterile, per 100 |
4,074 |
2,958 |
$33K |
| K0003 |
Lightweight wheelchair |
1,527 |
1,378 |
$33K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
3,047 |
2,770 |
$32K |
| K0007 |
Extra heavy duty wheelchair |
962 |
865 |
$32K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
13,468 |
11,871 |
$31K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
685 |
559 |
$30K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
2,553 |
2,272 |
$29K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
3,480 |
3,151 |
$27K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,726 |
2,654 |
$26K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
5,446 |
3,947 |
$26K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
314 |
261 |
$26K |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
441 |
397 |
$22K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
4,939 |
3,771 |
$21K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
10,439 |
8,091 |
$20K |
| A7012 |
Water collection device, used with large volume nebulizer |
5,008 |
3,528 |
$18K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
239 |
179 |
$18K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
85 |
64 |
$17K |
| A6550 |
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories |
143 |
109 |
$13K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
513 |
460 |
$13K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
111 |
90 |
$12K |
| 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) |
221 |
202 |
$12K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
223 |
175 |
$12K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
3,707 |
3,254 |
$12K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,008 |
853 |
$12K |
| A4322 |
Irrigation syringe, bulb or piston, each |
344 |
239 |
$10K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
294 |
231 |
$9K |
| E0184 |
Dry pressure mattress |
678 |
591 |
$9K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
198 |
157 |
$8K |
| E1399 |
Durable medical equipment, miscellaneous |
60 |
38 |
$7K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
167 |
130 |
$7K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
394 |
359 |
$7K |
| A7525 |
Tracheostomy mask, each |
5,549 |
3,928 |
$7K |
| E0156 |
Seat attachment, walker |
1,715 |
1,484 |
$7K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
337 |
293 |
$6K |
| A4554 |
Disposable underpads, all sizes |
429 |
309 |
$5K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
61 |
50 |
$5K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
474 |
401 |
$5K |
| A4456 |
Adhesive remover, wipes, any type, each |
276 |
212 |
$4K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
25 |
24 |
$4K |
| E0168 |
Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each |
151 |
138 |
$4K |
| A5120 |
Skin barrier, wipes or swabs, each |
539 |
422 |
$3K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
245 |
207 |
$3K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
33 |
25 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
3,495 |
2,912 |
$3K |
| E2202 |
Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches |
415 |
383 |
$3K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
27 |
26 |
$3K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
294 |
218 |
$3K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
623 |
319 |
$2K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
892 |
840 |
$2K |
| K0002 |
Standard hemi (low seat) wheelchair |
141 |
130 |
$2K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
122 |
85 |
$2K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
47 |
46 |
$1K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
324 |
288 |
$1K |
| A4371 |
Ostomy skin barrier, powder, per oz |
306 |
266 |
$1K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
32 |
26 |
$940.14 |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
15 |
14 |
$794.57 |
| A4565 |
Slings |
107 |
104 |
$491.29 |
| E0550 |
Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery |
46 |
28 |
$488.73 |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
21 |
12 |
$320.56 |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
14 |
12 |
$257.51 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
141 |
125 |
$147.97 |
| A4405 |
Ostomy skin barrier, non-pectin based, paste, per ounce |
14 |
12 |
$112.32 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
13 |
12 |
$92.94 |