| 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 |
20,590 |
20,046 |
$1.72M |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
3,140 |
3,027 |
$305K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,546 |
1,364 |
$301K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
17,760 |
17,090 |
$266K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,538 |
2,460 |
$237K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,692 |
3,629 |
$185K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,635 |
1,587 |
$161K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,088 |
1,050 |
$133K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,614 |
2,519 |
$128K |
| 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) |
1,102 |
1,067 |
$125K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
786 |
768 |
$104K |
| K0001 |
Standard wheelchair |
3,953 |
3,840 |
$76K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
763 |
737 |
$75K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
499 |
493 |
$64K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,631 |
1,587 |
$62K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
430 |
424 |
$61K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,618 |
1,592 |
$61K |
| B9998 |
Noc for enteral supplies |
315 |
297 |
$47K |
| 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 |
80 |
74 |
$35K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,630 |
4,474 |
$34K |
| A4927 |
Gloves, non-sterile, per 100 |
3,164 |
3,046 |
$34K |
| A7035 |
Headgear used with positive airway pressure device |
1,844 |
1,777 |
$34K |
| E0570 |
Nebulizer, with compressor |
2,016 |
1,970 |
$31K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
179 |
177 |
$28K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
988 |
980 |
$21K |
| E1392 |
Portable oxygen concentrator, rental |
594 |
591 |
$19K |
| A7037 |
Tubing used with positive airway pressure device |
1,143 |
1,113 |
$19K |
| K0003 |
Lightweight wheelchair |
528 |
511 |
$18K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
2,887 |
2,600 |
$17K |
| B9002 |
Enteral nutrition infusion pump, any type |
227 |
220 |
$17K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,237 |
1,212 |
$14K |
| A4452 |
Tape, waterproof, per 18 square inches |
278 |
264 |
$7K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
447 |
412 |
$5K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
77 |
77 |
$5K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
25 |
25 |
$4K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
181 |
180 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
37 |
37 |
$2K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
14 |
12 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
12 |
12 |
$609.98 |
| E0776 |
Iv pole |
66 |
65 |
$537.33 |
| A4322 |
Irrigation syringe, bulb or piston, each |
24 |
24 |
$291.16 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
87 |
83 |
$108.10 |
| A7015 |
Aerosol mask, used with dme nebulizer |
12 |
12 |
$15.52 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
15 |
12 |
$11.84 |