| 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 |
8,989 |
7,994 |
$343K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,761 |
3,526 |
$143K |
| E0570 |
Nebulizer, with compressor |
3,377 |
2,902 |
$115K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,460 |
3,275 |
$95K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,770 |
1,605 |
$88K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,295 |
2,003 |
$48K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,707 |
1,543 |
$47K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,162 |
4,618 |
$47K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,473 |
4,124 |
$47K |
| K0001 |
Standard wheelchair |
3,641 |
3,179 |
$38K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,057 |
945 |
$31K |
| A7037 |
Tubing used with positive airway pressure device |
3,214 |
3,015 |
$30K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
246 |
236 |
$28K |
| 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) |
438 |
380 |
$27K |
| A7035 |
Headgear used with positive airway pressure device |
1,897 |
1,776 |
$25K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,694 |
5,353 |
$18K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
407 |
295 |
$14K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
69 |
64 |
$13K |
| A6238 |
Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
210 |
198 |
$12K |
| E1392 |
Portable oxygen concentrator, rental |
872 |
702 |
$11K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,052 |
974 |
$10K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,380 |
1,293 |
$6K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
106 |
99 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,768 |
1,625 |
$4K |
| A4456 |
Adhesive remover, wipes, any type, each |
443 |
407 |
$3K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
105 |
92 |
$3K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
48 |
35 |
$1K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
154 |
125 |
$1K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
12 |
12 |
$431.28 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
14 |
14 |
$379.30 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
46 |
38 |
$173.80 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
117 |
88 |
$138.08 |
| E0156 |
Seat attachment, walker |
12 |
12 |
$96.91 |
| A7015 |
Aerosol mask, used with dme nebulizer |
26 |
26 |
$34.37 |