| 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 |
4,013 |
3,804 |
$158K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,841 |
2,782 |
$137K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
356 |
348 |
$39K |
| 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 |
1,715 |
1,649 |
$39K |
| E0570 |
Nebulizer, with compressor |
1,683 |
1,605 |
$39K |
| 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) |
260 |
253 |
$33K |
| A7030 |
Full face mask used with positive airway pressure device, each |
611 |
572 |
$32K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,018 |
1,006 |
$27K |
| K0001 |
Standard wheelchair |
1,167 |
1,150 |
$20K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
813 |
765 |
$20K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,104 |
1,023 |
$14K |
| E1392 |
Portable oxygen concentrator, rental |
380 |
368 |
$14K |
| A7035 |
Headgear used with positive airway pressure device |
741 |
698 |
$13K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
130 |
124 |
$11K |
| A7031 |
Face mask interface, replacement for full face mask, each |
398 |
357 |
$9K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
132 |
83 |
$8K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
263 |
253 |
$8K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
98 |
87 |
$8K |
| T4541 |
Incontinence product, disposable underpad, large, each |
310 |
275 |
$7K |
| K0007 |
Extra heavy duty wheelchair |
109 |
100 |
$6K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
223 |
217 |
$5K |
| K0006 |
Heavy duty wheelchair |
140 |
137 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
281 |
268 |
$4K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
321 |
276 |
$4K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
62 |
43 |
$4K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
133 |
119 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,278 |
1,144 |
$3K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
102 |
90 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
536 |
531 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
514 |
486 |
$866.92 |
| A4927 |
Gloves, non-sterile, per 100 |
106 |
92 |
$789.49 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
145 |
133 |
$748.43 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
14 |
12 |
$366.61 |
| A7037 |
Tubing used with positive airway pressure device |
24 |
24 |
$277.79 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
14 |
13 |
$277.19 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
90 |
81 |
$239.24 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
13 |
13 |
$213.05 |
| E0156 |
Seat attachment, walker |
13 |
12 |
$154.29 |
| A7015 |
Aerosol mask, used with dme nebulizer |
13 |
12 |
$14.87 |