| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
4,122 |
2,704 |
$2.80M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
3,871 |
2,606 |
$1.63M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
12,205 |
9,475 |
$1.15M |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
6,233 |
5,461 |
$974K |
| E1399 |
Durable medical equipment, miscellaneous |
3,434 |
2,069 |
$962K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
2,002 |
1,778 |
$513K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
3,230 |
2,406 |
$352K |
| A4623 |
Tracheostomy, inner cannula |
3,138 |
2,023 |
$328K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
9,788 |
7,632 |
$276K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
3,945 |
2,755 |
$276K |
| E0570 |
Nebulizer, with compressor |
2,612 |
2,298 |
$229K |
| A4217 |
Sterile water/saline, 500 ml |
5,293 |
3,337 |
$214K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,403 |
2,348 |
$131K |
| A7526 |
Tracheostomy tube collar/holder, each |
3,895 |
2,898 |
$101K |
| A7000 |
Canister, disposable, used with suction pump, each |
4,891 |
3,741 |
$101K |
| L8501 |
Tracheostomy speaking valve |
1,756 |
1,229 |
$93K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,774 |
1,068 |
$75K |
| E0619 |
Apnea monitor, with recording feature |
299 |
259 |
$58K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,435 |
1,047 |
$50K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,208 |
2,037 |
$48K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
1,347 |
1,260 |
$48K |
| A7030 |
Full face mask used with positive airway pressure device, each |
532 |
434 |
$42K |
| W4047 |
|
2,411 |
1,655 |
$31K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
3,137 |
2,677 |
$29K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
396 |
251 |
$27K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
234 |
184 |
$26K |
| K0001 |
Standard wheelchair |
763 |
657 |
$25K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
89 |
61 |
$21K |
| A7037 |
Tubing used with positive airway pressure device |
1,102 |
923 |
$21K |
| A7035 |
Headgear used with positive airway pressure device |
1,032 |
871 |
$19K |
| E1235 |
Wheelchair, pediatric size, rigid, adjustable, with seating system |
118 |
114 |
$17K |
| A7002 |
Tubing, used with suction pump, each |
4,565 |
3,734 |
$17K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
229 |
202 |
$16K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,729 |
1,136 |
$13K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
902 |
788 |
$13K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
443 |
285 |
$11K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,650 |
2,263 |
$11K |
| 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) |
131 |
85 |
$9K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
1,983 |
1,447 |
$8K |
| A7525 |
Tracheostomy mask, each |
2,463 |
1,764 |
$7K |
| A7012 |
Water collection device, used with large volume nebulizer |
1,890 |
1,384 |
$7K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
3,477 |
2,927 |
$6K |
| A4402 |
Lubricant, per ounce |
1,742 |
1,295 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,787 |
2,405 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,139 |
928 |
$4K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
226 |
191 |
$3K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
2,076 |
1,705 |
$2K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
534 |
454 |
$1K |
| A7031 |
Face mask interface, replacement for full face mask, each |
43 |
31 |
$987.21 |
| W4670 |
|
99 |
65 |
$660.00 |
| A4614 |
Peak expiratory flow rate meter, hand held |
24 |
18 |
$476.59 |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
13 |
13 |
$462.79 |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
16 |
16 |
$0.00 |