| 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 |
4,946 |
4,696 |
$245K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,102 |
1,919 |
$113K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,925 |
1,813 |
$67K |
| A7030 |
Full face mask used with positive airway pressure device, each |
680 |
654 |
$59K |
| E0570 |
Nebulizer, with compressor |
2,163 |
2,007 |
$47K |
| K0001 |
Standard wheelchair |
2,475 |
2,364 |
$46K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,676 |
2,521 |
$24K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,679 |
1,650 |
$24K |
| A7037 |
Tubing used with positive airway pressure device |
1,083 |
1,024 |
$19K |
| A7035 |
Headgear used with positive airway pressure device |
814 |
763 |
$13K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,422 |
1,335 |
$8K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
175 |
168 |
$7K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
132 |
129 |
$7K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
152 |
151 |
$6K |
| 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) |
63 |
63 |
$6K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
619 |
610 |
$6K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,091 |
1,046 |
$5K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
56 |
55 |
$4K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,196 |
1,117 |
$4K |
| T4541 |
Incontinence product, disposable underpad, large, each |
277 |
258 |
$4K |
| E1392 |
Portable oxygen concentrator, rental |
474 |
458 |
$3K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
239 |
214 |
$2K |
| K0006 |
Heavy duty wheelchair |
51 |
50 |
$2K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
75 |
70 |
$1K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
14 |
12 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
321 |
315 |
$871.12 |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
13 |
13 |
$857.70 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
13 |
13 |
$437.83 |
| A7031 |
Face mask interface, replacement for full face mask, each |
15 |
15 |
$423.79 |
| A4927 |
Gloves, non-sterile, per 100 |
30 |
26 |
$338.10 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
17 |
17 |
$174.77 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
12 |
12 |
$82.56 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
95 |
94 |
$48.88 |
| A7015 |
Aerosol mask, used with dme nebulizer |
15 |
14 |
$13.93 |
| A9270 |
Non-covered item or service |
37 |
26 |
$0.00 |