| 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 |
5,380 |
5,308 |
$350K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
348 |
341 |
$158K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,168 |
3,094 |
$138K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
659 |
658 |
$95K |
| E0570 |
Nebulizer, with compressor |
2,177 |
2,161 |
$84K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,122 |
1,115 |
$63K |
| E1392 |
Portable oxygen concentrator, rental |
1,063 |
1,057 |
$57K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,076 |
1,043 |
$45K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,402 |
2,364 |
$38K |
| 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) |
238 |
233 |
$30K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
239 |
219 |
$28K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
579 |
577 |
$15K |
| A7031 |
Face mask interface, replacement for full face mask, each |
576 |
573 |
$14K |
| A7035 |
Headgear used with positive airway pressure device |
1,333 |
1,325 |
$13K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
616 |
614 |
$12K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
225 |
225 |
$11K |
| A7037 |
Tubing used with positive airway pressure device |
1,446 |
1,443 |
$10K |
| K0001 |
Standard wheelchair |
411 |
397 |
$8K |
| 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 |
656 |
654 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,283 |
2,268 |
$5K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
110 |
108 |
$4K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
176 |
176 |
$3K |
| A7000 |
Canister, disposable, used with suction pump, each |
316 |
301 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,266 |
1,240 |
$3K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,203 |
1,199 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
196 |
194 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
195 |
175 |
$2K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
12 |
12 |
$2K |
| A7002 |
Tubing, used with suction pump, each |
615 |
389 |
$1K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
176 |
156 |
$1K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
12 |
12 |
$568.06 |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
12 |
12 |
$418.85 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
198 |
198 |
$383.50 |
| A4927 |
Gloves, non-sterile, per 100 |
61 |
58 |
$204.55 |
| A4618 |
Breathing circuits |
41 |
37 |
$161.01 |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
13 |
13 |
$95.62 |
| A7015 |
Aerosol mask, used with dme nebulizer |
97 |
94 |
$89.17 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
12 |
12 |
$26.89 |