| 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 |
11,334 |
10,555 |
$888K |
| E0601 |
Continuous positive airway pressure (cpap) device |
6,033 |
5,732 |
$342K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,171 |
2,053 |
$212K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,064 |
1,016 |
$171K |
| E0570 |
Nebulizer, with compressor |
5,730 |
5,381 |
$147K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,283 |
1,220 |
$127K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,344 |
3,152 |
$118K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
842 |
800 |
$104K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,498 |
1,413 |
$97K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,843 |
1,720 |
$90K |
| K0001 |
Standard wheelchair |
3,700 |
3,510 |
$88K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
563 |
535 |
$84K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,709 |
1,593 |
$82K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
533 |
511 |
$79K |
| A7035 |
Headgear used with positive airway pressure device |
3,222 |
3,071 |
$66K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,710 |
1,632 |
$65K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
627 |
521 |
$56K |
| E1392 |
Portable oxygen concentrator, rental |
4,016 |
3,760 |
$54K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,411 |
3,214 |
$49K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
809 |
795 |
$47K |
| 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) |
472 |
458 |
$46K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,034 |
981 |
$42K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
1,510 |
1,436 |
$36K |
| A4927 |
Gloves, non-sterile, per 100 |
2,047 |
1,893 |
$34K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,869 |
1,747 |
$33K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,526 |
1,507 |
$32K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
886 |
722 |
$29K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
210 |
210 |
$28K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,439 |
4,210 |
$24K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
593 |
586 |
$22K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,151 |
2,030 |
$21K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
484 |
478 |
$19K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,086 |
1,031 |
$16K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
108 |
108 |
$11K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
200 |
186 |
$9K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
91 |
90 |
$8K |
| A4335 |
Incontinence supply; miscellaneous |
626 |
542 |
$8K |
| A4245 |
Alcohol wipes, per box |
124 |
113 |
$7K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
188 |
175 |
$7K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
138 |
125 |
$5K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
18 |
12 |
$4K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
26 |
25 |
$4K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
27 |
25 |
$3K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
82 |
73 |
$3K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
65 |
58 |
$2K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
282 |
225 |
$2K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
43 |
36 |
$2K |
| A4554 |
Disposable underpads, all sizes |
133 |
118 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
70 |
52 |
$1K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
28 |
25 |
$1K |
| E0156 |
Seat attachment, walker |
85 |
81 |
$817.88 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
86 |
75 |
$715.84 |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
40 |
39 |
$497.09 |
| A7037 |
Tubing used with positive airway pressure device |
15 |
15 |
$352.76 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
18 |
13 |
$71.61 |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
14 |
14 |
$5.27 |