| 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 |
135,620 |
134,664 |
$10.75M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
9,501 |
9,226 |
$3.13M |
| E0601 |
Continuous positive airway pressure (cpap) device |
31,497 |
31,395 |
$1.63M |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
2,988 |
2,226 |
$1.50M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
102,406 |
101,291 |
$1.42M |
| E1392 |
Portable oxygen concentrator, rental |
45,443 |
45,137 |
$1.17M |
| K0001 |
Standard wheelchair |
43,655 |
42,868 |
$1.04M |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
6,337 |
6,251 |
$948K |
| E0277 |
Powered pressure-reducing air mattress |
2,445 |
2,339 |
$879K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
6,606 |
6,547 |
$843K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
2,391 |
2,380 |
$835K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
15,001 |
11,825 |
$793K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
16,631 |
16,556 |
$691K |
| 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) |
5,325 |
5,307 |
$679K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
10,114 |
10,061 |
$622K |
| E0570 |
Nebulizer, with compressor |
16,565 |
16,493 |
$586K |
| A7030 |
Full face mask used with positive airway pressure device, each |
6,736 |
6,695 |
$542K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
17,370 |
17,277 |
$485K |
| E2402 |
Negative pressure wound therapy electrical pump, stationary or portable |
686 |
616 |
$439K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
7,140 |
7,066 |
$434K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
3,574 |
3,555 |
$433K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
10,963 |
10,780 |
$413K |
| A7035 |
Headgear used with positive airway pressure device |
18,132 |
18,002 |
$402K |
| A4623 |
Tracheostomy, inner cannula |
1,659 |
1,619 |
$304K |
| K0003 |
Lightweight wheelchair |
9,535 |
9,453 |
$287K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
6,671 |
6,585 |
$276K |
| A7031 |
Face mask interface, replacement for full face mask, each |
6,509 |
6,470 |
$256K |
| E0483 |
High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each |
515 |
514 |
$238K |
| E0144 |
Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat |
3,122 |
3,086 |
$223K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
7,117 |
6,975 |
$214K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
14,734 |
14,662 |
$212K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
7,149 |
7,083 |
$205K |
| E0441 |
Stationary oxygen contents, gaseous, 1 month's supply = 1 unit |
522 |
300 |
$191K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
14,116 |
14,051 |
$177K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,722 |
1,712 |
$159K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,744 |
1,713 |
$145K |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
1,145 |
1,141 |
$142K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
2,904 |
2,874 |
$135K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
874 |
768 |
$135K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
1,927 |
1,917 |
$133K |
| A7526 |
Tracheostomy tube collar/holder, each |
2,364 |
2,267 |
$131K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,829 |
1,743 |
$128K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
6,678 |
6,594 |
$127K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
416 |
415 |
$116K |
| K0006 |
Heavy duty wheelchair |
2,029 |
2,017 |
$115K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
1,930 |
1,873 |
$93K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
8,222 |
8,049 |
$91K |
| A7000 |
Canister, disposable, used with suction pump, each |
5,254 |
4,778 |
$89K |
| A6550 |
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories |
606 |
453 |
$74K |
| E0271 |
Mattress, innerspring |
2,082 |
2,060 |
$65K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
960 |
951 |
$63K |
| S8189 |
Tracheostomy supply, not otherwise classified |
4,287 |
1,610 |
$59K |
| L8501 |
Tracheostomy speaking valve |
356 |
345 |
$51K |
| A7037 |
Tubing used with positive airway pressure device |
2,621 |
2,583 |
$51K |
| A4927 |
Gloves, non-sterile, per 100 |
2,978 |
2,629 |
$49K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
1,594 |
1,576 |
$46K |
| K0007 |
Extra heavy duty wheelchair |
593 |
592 |
$46K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
3,857 |
3,450 |
$45K |
| A4605 |
Tracheal suction catheter, closed system, each |
573 |
536 |
$41K |
| A4670 |
Automatic blood pressure monitor |
853 |
851 |
$39K |
| E0305 |
Bed side rails, half length |
3,324 |
3,312 |
$33K |
| E0310 |
Bed side rails, full length |
2,514 |
2,471 |
$31K |
| A7002 |
Tubing, used with suction pump, each |
5,162 |
4,102 |
$30K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
932 |
926 |
$28K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
1,309 |
1,298 |
$27K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,263 |
1,173 |
$26K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
3,304 |
3,091 |
$21K |
| E0635 |
Patient lift, electric with seat or sling |
265 |
265 |
$19K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
2,006 |
2,000 |
$17K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
837 |
800 |
$15K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
1,317 |
1,291 |
$15K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
403 |
402 |
$14K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
152 |
149 |
$14K |
| A4217 |
Sterile water/saline, 500 ml |
725 |
713 |
$14K |
| E0272 |
Mattress, foam rubber |
177 |
177 |
$14K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
2,193 |
2,182 |
$13K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
52 |
52 |
$12K |
| E0168 |
Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each |
243 |
241 |
$11K |
| A7036 |
Chinstrap used with positive airway pressure device |
981 |
972 |
$11K |
| A7504 |
Filter for use in a tracheostoma heat and moisture exchange system, each |
1,765 |
1,467 |
$10K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
1,309 |
1,220 |
$8K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
3,760 |
2,849 |
$8K |
| A7525 |
Tracheostomy mask, each |
1,595 |
1,530 |
$8K |
| E0156 |
Seat attachment, walker |
1,231 |
1,219 |
$6K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
924 |
923 |
$6K |
| A7015 |
Aerosol mask, used with dme nebulizer |
4,476 |
4,442 |
$5K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
152 |
148 |
$4K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
430 |
430 |
$3K |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
49 |
49 |
$779.30 |
| E0912 |
Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar |
12 |
12 |
$532.51 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
57 |
57 |
$490.93 |
| A4615 |
Cannula, nasal |
519 |
482 |
$332.87 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
48 |
48 |
$293.61 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
142 |
142 |
$263.85 |
| A4402 |
Lubricant, per ounce |
577 |
576 |
$168.24 |
| E0940 |
Trapeze bar, free standing, complete with grab bar |
25 |
25 |
$122.42 |
| A4616 |
Tubing (oxygen), per foot |
100 |
96 |
$0.12 |