| 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 |
10,643 |
9,341 |
$1.02M |
| E0601 |
Continuous positive airway pressure (cpap) device |
10,236 |
8,884 |
$743K |
| E0570 |
Nebulizer, with compressor |
5,251 |
4,917 |
$403K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
6,229 |
5,620 |
$306K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,725 |
1,350 |
$306K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
5,878 |
5,401 |
$291K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,284 |
1,212 |
$249K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,252 |
2,014 |
$233K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
1,175 |
1,116 |
$227K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,918 |
2,632 |
$213K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
8,245 |
7,415 |
$142K |
| 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 |
5,597 |
4,987 |
$142K |
| A7035 |
Headgear used with positive airway pressure device |
5,246 |
4,799 |
$125K |
| B9998 |
Noc for enteral supplies |
1,809 |
1,012 |
$92K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,903 |
2,806 |
$72K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
971 |
890 |
$55K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,945 |
1,822 |
$43K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,074 |
943 |
$41K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
4,136 |
3,779 |
$38K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
999 |
960 |
$34K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,356 |
2,136 |
$27K |
| A7037 |
Tubing used with positive airway pressure device |
7,682 |
7,021 |
$25K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
187 |
170 |
$22K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
76 |
74 |
$17K |
| K0001 |
Standard wheelchair |
733 |
625 |
$17K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
139 |
119 |
$13K |
| A7000 |
Canister, disposable, used with suction pump, each |
659 |
544 |
$12K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
21 |
12 |
$10K |
| 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) |
78 |
64 |
$10K |
| A7002 |
Tubing, used with suction pump, each |
900 |
573 |
$9K |
| E1399 |
Durable medical equipment, miscellaneous |
489 |
166 |
$9K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
87 |
64 |
$8K |
| A7526 |
Tracheostomy tube collar/holder, each |
447 |
338 |
$5K |
| A4217 |
Sterile water/saline, 500 ml |
255 |
202 |
$4K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
85 |
82 |
$4K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
31 |
28 |
$4K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
309 |
157 |
$4K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
52 |
39 |
$3K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,134 |
474 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
120 |
92 |
$2K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
12 |
12 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
220 |
139 |
$1K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
205 |
162 |
$966.03 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
590 |
474 |
$962.42 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
414 |
369 |
$922.25 |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
13 |
13 |
$847.34 |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
12 |
12 |
$822.67 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
119 |
88 |
$683.30 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
20 |
16 |
$497.40 |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
16 |
12 |
$355.76 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
30 |
24 |
$291.84 |
| A7015 |
Aerosol mask, used with dme nebulizer |
154 |
128 |
$263.12 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
233 |
193 |
$247.90 |