| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
22,274 |
21,737 |
$1.08M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
15,154 |
14,184 |
$731K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
20,394 |
20,177 |
$277K |
| A7030 |
Full face mask used with positive airway pressure device, each |
4,897 |
4,625 |
$269K |
| 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) |
3,142 |
2,979 |
$263K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
4,492 |
4,240 |
$138K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,006 |
874 |
$133K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
10,842 |
10,366 |
$132K |
| K0001 |
Standard wheelchair |
6,554 |
6,308 |
$114K |
| E0570 |
Nebulizer, with compressor |
4,124 |
3,941 |
$96K |
| A7035 |
Headgear used with positive airway pressure device |
5,799 |
5,505 |
$88K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,369 |
2,246 |
$78K |
| A7037 |
Tubing used with positive airway pressure device |
4,925 |
4,816 |
$76K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,594 |
6,924 |
$74K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,260 |
2,051 |
$55K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,295 |
1,235 |
$48K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
262 |
261 |
$31K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,102 |
1,091 |
$29K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
232 |
165 |
$20K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,547 |
1,328 |
$16K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
565 |
498 |
$15K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
525 |
525 |
$15K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
63 |
48 |
$14K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,823 |
1,786 |
$10K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
72 |
70 |
$10K |
| K0007 |
Extra heavy duty wheelchair |
234 |
227 |
$9K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,502 |
1,437 |
$9K |
| 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) |
77 |
75 |
$8K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
127 |
127 |
$8K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
58 |
57 |
$8K |
| T4541 |
Incontinence product, disposable underpad, large, each |
360 |
268 |
$8K |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
270 |
267 |
$8K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
54 |
51 |
$8K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
468 |
448 |
$7K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
221 |
185 |
$6K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
38 |
35 |
$5K |
| E0156 |
Seat attachment, walker |
1,163 |
1,120 |
$5K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
117 |
108 |
$5K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
93 |
93 |
$5K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
64 |
37 |
$5K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
193 |
189 |
$5K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
161 |
161 |
$4K |
| 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 |
574 |
559 |
$4K |
| E0635 |
Patient lift, electric with seat or sling |
53 |
53 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
184 |
174 |
$2K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
43 |
43 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
228 |
160 |
$2K |
| E0561 |
Humidifier, non-heated, used with positive airway pressure device |
210 |
210 |
$2K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
13 |
12 |
$1K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
20 |
12 |
$1K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
101 |
99 |
$1K |
| L3260 |
Surgical boot/shoe, each |
63 |
63 |
$1K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
64 |
64 |
$1K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
33 |
14 |
$803.95 |
| E0245 |
Tub stool or bench |
13 |
13 |
$762.15 |
| S5199 |
Personal care item, nos, each |
45 |
44 |
$504.72 |
| A4456 |
Adhesive remover, wipes, any type, each |
36 |
36 |
$342.30 |
| A5120 |
Skin barrier, wipes or swabs, each |
29 |
28 |
$208.10 |
| A4259 |
Lancets, per box of 100 |
54 |
53 |
$199.94 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
172 |
148 |
$154.30 |
| A7036 |
Chinstrap used with positive airway pressure device |
12 |
12 |
$76.61 |
| A7015 |
Aerosol mask, used with dme nebulizer |
17 |
12 |
$12.99 |