| 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 |
2,670 |
2,375 |
$171K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,987 |
1,708 |
$55K |
| E0570 |
Nebulizer, with compressor |
1,689 |
1,441 |
$47K |
| E0601 |
Continuous positive airway pressure (cpap) device |
992 |
923 |
$36K |
| B9998 |
Noc for enteral supplies |
223 |
177 |
$32K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,253 |
2,055 |
$30K |
| K0003 |
Lightweight wheelchair |
1,514 |
1,319 |
$23K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
532 |
499 |
$20K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
82 |
73 |
$17K |
| A7030 |
Full face mask used with positive airway pressure device, each |
158 |
152 |
$12K |
| A7031 |
Face mask interface, replacement for full face mask, each |
277 |
268 |
$6K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
241 |
164 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
526 |
496 |
$4K |
| A4322 |
Irrigation syringe, bulb or piston, each |
37 |
37 |
$3K |
| E1399 |
Durable medical equipment, miscellaneous |
20 |
12 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
763 |
628 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
687 |
660 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
260 |
258 |
$2K |
| E0245 |
Tub stool or bench |
19 |
13 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
126 |
123 |
$1K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
17 |
16 |
$905.34 |
| K0001 |
Standard wheelchair |
81 |
62 |
$834.44 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
50 |
50 |
$761.85 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
27 |
26 |
$600.24 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
386 |
364 |
$316.36 |
| K0006 |
Heavy duty wheelchair |
14 |
12 |
$245.45 |
| E0156 |
Seat attachment, walker |
58 |
54 |
$198.30 |