| 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 |
31,246 |
29,219 |
$1.49M |
| E0601 |
Continuous positive airway pressure (cpap) device |
15,056 |
14,450 |
$732K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,588 |
1,508 |
$695K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,739 |
2,562 |
$270K |
| 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) |
2,291 |
2,193 |
$266K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,935 |
3,664 |
$211K |
| E1392 |
Portable oxygen concentrator, rental |
15,402 |
14,154 |
$206K |
| 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 |
5,412 |
5,076 |
$141K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
5,609 |
5,281 |
$132K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,907 |
5,489 |
$110K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,130 |
2,965 |
$100K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,472 |
2,276 |
$94K |
| A7035 |
Headgear used with positive airway pressure device |
5,065 |
4,783 |
$94K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,703 |
2,461 |
$74K |
| E0570 |
Nebulizer, with compressor |
3,548 |
3,285 |
$68K |
| K0001 |
Standard wheelchair |
2,152 |
2,016 |
$58K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
382 |
352 |
$31K |
| 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 |
36 |
30 |
$26K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,120 |
1,054 |
$23K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
8,428 |
7,687 |
$20K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
103 |
95 |
$18K |
| 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 |
102 |
65 |
$13K |
| 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) |
58 |
58 |
$11K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
47 |
37 |
$11K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
459 |
411 |
$10K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
286 |
262 |
$10K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
125 |
119 |
$10K |
| A7037 |
Tubing used with positive airway pressure device |
517 |
479 |
$8K |
| 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 |
49 |
43 |
$8K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,904 |
1,761 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
332 |
318 |
$4K |
| B9002 |
Enteral nutrition infusion pump, any type |
35 |
32 |
$3K |
| A4670 |
Automatic blood pressure monitor |
46 |
46 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
26 |
22 |
$1K |
| B9998 |
Noc for enteral supplies |
29 |
29 |
$1K |
| K0006 |
Heavy duty wheelchair |
19 |
18 |
$1K |
| E0245 |
Tub stool or bench |
38 |
38 |
$1K |
| A4623 |
Tracheostomy, inner cannula |
15 |
14 |
$1K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
231 |
219 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
738 |
707 |
$939.71 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
13 |
13 |
$725.25 |
| A4629 |
Tracheostomy care kit for established tracheostomy |
14 |
13 |
$701.66 |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
12 |
12 |
$568.16 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
66 |
57 |
$524.38 |
| E0244 |
Raised toilet seat |
12 |
12 |
$459.61 |
| A7036 |
Chinstrap used with positive airway pressure device |
41 |
41 |
$381.80 |
| A7000 |
Canister, disposable, used with suction pump, each |
14 |
14 |
$139.73 |
| A7015 |
Aerosol mask, used with dme nebulizer |
73 |
72 |
$72.71 |
| E1356 |
Oxygen accessory, battery pack/cartridge for portable concentrator, any type, replacement only, each |
276 |
275 |
$0.00 |