| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
1,037 |
870 |
$273K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,776 |
3,326 |
$246K |
| E0570 |
Nebulizer, with compressor |
1,133 |
1,077 |
$142K |
| S8189 |
Tracheostomy supply, not otherwise classified |
1,728 |
367 |
$112K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
353 |
321 |
$75K |
| A7030 |
Full face mask used with positive airway pressure device, each |
594 |
563 |
$46K |
| E1399 |
Durable medical equipment, miscellaneous |
368 |
229 |
$44K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,114 |
945 |
$40K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,353 |
2,177 |
$34K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
242 |
222 |
$34K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
172 |
154 |
$31K |
| A4217 |
Sterile water/saline, 500 ml |
254 |
215 |
$29K |
| A7526 |
Tracheostomy tube collar/holder, each |
253 |
232 |
$26K |
| A7035 |
Headgear used with positive airway pressure device |
1,105 |
1,053 |
$19K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
430 |
410 |
$15K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,459 |
1,390 |
$14K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
115 |
109 |
$14K |
| A4618 |
Breathing circuits |
228 |
207 |
$12K |
| B9998 |
Noc for enteral supplies |
74 |
37 |
$11K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
76 |
68 |
$11K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
209 |
199 |
$11K |
| A7031 |
Face mask interface, replacement for full face mask, each |
288 |
276 |
$9K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
57 |
52 |
$8K |
| A7000 |
Canister, disposable, used with suction pump, each |
340 |
313 |
$8K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
289 |
284 |
$7K |
| K0001 |
Standard wheelchair |
100 |
88 |
$6K |
| A7006 |
Administration set, with small volume filtered pneumatic nebulizer |
971 |
925 |
$6K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
76 |
49 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,856 |
1,765 |
$5K |
| A7002 |
Tubing, used with suction pump, each |
341 |
309 |
$5K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
245 |
226 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,071 |
1,986 |
$4K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
84 |
81 |
$4K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,235 |
2,120 |
$4K |
| A7037 |
Tubing used with positive airway pressure device |
263 |
250 |
$3K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
231 |
215 |
$3K |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
885 |
848 |
$2K |
| A4452 |
Tape, waterproof, per 18 square inches |
167 |
151 |
$2K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
116 |
106 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
178 |
164 |
$2K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
14 |
12 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
225 |
205 |
$2K |
| A7525 |
Tracheostomy mask, each |
166 |
156 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
12 |
12 |
$426.83 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
729 |
690 |
$344.74 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
53 |
52 |
$289.86 |
| A4332 |
Lubricant, individual sterile packet, each |
119 |
108 |
$127.42 |