| 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 |
21,745 |
21,362 |
$2.24M |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,655 |
3,633 |
$376K |
| E0601 |
Continuous positive airway pressure (cpap) device |
6,012 |
5,974 |
$357K |
| E0570 |
Nebulizer, with compressor |
18,123 |
18,043 |
$347K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
13,293 |
12,967 |
$248K |
| 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) |
1,837 |
1,834 |
$226K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,827 |
3,797 |
$209K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,040 |
875 |
$188K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,044 |
3,029 |
$124K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,077 |
1,052 |
$118K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
907 |
905 |
$118K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,052 |
1,030 |
$113K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
722 |
712 |
$107K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,766 |
1,762 |
$101K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
907 |
887 |
$101K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
681 |
676 |
$92K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
608 |
593 |
$90K |
| K0001 |
Standard wheelchair |
3,469 |
3,426 |
$90K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,579 |
1,560 |
$86K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,368 |
7,289 |
$60K |
| A7035 |
Headgear used with positive airway pressure device |
2,972 |
2,934 |
$59K |
| E1392 |
Portable oxygen concentrator, rental |
1,632 |
1,626 |
$57K |
| K0003 |
Lightweight wheelchair |
1,021 |
1,001 |
$47K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
282 |
270 |
$46K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
644 |
634 |
$41K |
| E0202 |
Phototherapy (bilirubin) light with photometer |
802 |
192 |
$40K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
666 |
660 |
$36K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
507 |
503 |
$26K |
| A7037 |
Tubing used with positive airway pressure device |
1,355 |
1,344 |
$26K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,072 |
2,050 |
$25K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
145 |
144 |
$24K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
144 |
131 |
$21K |
| B9998 |
Noc for enteral supplies |
180 |
147 |
$20K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
142 |
142 |
$19K |
| A4927 |
Gloves, non-sterile, per 100 |
1,689 |
1,598 |
$18K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
66 |
66 |
$16K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
2,373 |
2,178 |
$14K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,268 |
1,259 |
$8K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
349 |
338 |
$4K |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
2,371 |
2,347 |
$3K |
| E1399 |
Durable medical equipment, miscellaneous |
40 |
38 |
$3K |
| 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 |
12 |
12 |
$3K |
| B9002 |
Enteral nutrition infusion pump, any type |
40 |
39 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,788 |
1,767 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,238 |
1,230 |
$3K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
50 |
49 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
165 |
143 |
$2K |
| A4670 |
Automatic blood pressure monitor |
12 |
12 |
$598.86 |
| A7526 |
Tracheostomy tube collar/holder, each |
12 |
12 |
$577.13 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
12 |
12 |
$538.91 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
12 |
12 |
$294.00 |
| E0156 |
Seat attachment, walker |
25 |
25 |
$228.47 |