| 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 |
40,025 |
33,205 |
$1.57M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,614 |
1,340 |
$564K |
| A7030 |
Full face mask used with positive airway pressure device, each |
6,188 |
5,650 |
$318K |
| E0601 |
Continuous positive airway pressure (cpap) device |
10,904 |
8,579 |
$304K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
21,652 |
18,905 |
$195K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
7,609 |
7,011 |
$182K |
| A7031 |
Face mask interface, replacement for full face mask, each |
7,519 |
6,736 |
$165K |
| E0570 |
Nebulizer, with compressor |
6,605 |
5,949 |
$142K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,625 |
3,185 |
$126K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
4,026 |
3,385 |
$113K |
| 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) |
1,334 |
1,134 |
$99K |
| E1392 |
Portable oxygen concentrator, rental |
4,436 |
3,770 |
$82K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,163 |
2,039 |
$77K |
| A7035 |
Headgear used with positive airway pressure device |
5,947 |
5,526 |
$74K |
| K0001 |
Standard wheelchair |
4,332 |
3,778 |
$62K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,919 |
1,777 |
$44K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,563 |
1,505 |
$42K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
224 |
198 |
$39K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,618 |
3,425 |
$30K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
11,962 |
10,380 |
$26K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
135 |
129 |
$25K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
523 |
497 |
$18K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
152 |
148 |
$17K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
530 |
459 |
$14K |
| K0002 |
Standard hemi (low seat) wheelchair |
873 |
727 |
$14K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,908 |
1,644 |
$13K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,561 |
1,434 |
$13K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
819 |
776 |
$13K |
| A7037 |
Tubing used with positive airway pressure device |
1,305 |
1,204 |
$10K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
78 |
76 |
$10K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
48 |
46 |
$10K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
715 |
387 |
$9K |
| A7526 |
Tracheostomy tube collar/holder, each |
108 |
95 |
$8K |
| 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) |
38 |
37 |
$6K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
230 |
222 |
$6K |
| K0003 |
Lightweight wheelchair |
292 |
269 |
$6K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
138 |
136 |
$5K |
| 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 |
397 |
279 |
$5K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
42 |
37 |
$5K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
31 |
31 |
$5K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
62 |
61 |
$4K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
99 |
96 |
$4K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
86 |
78 |
$3K |
| E0156 |
Seat attachment, walker |
282 |
272 |
$3K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
50 |
46 |
$2K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
34 |
34 |
$2K |
| A7000 |
Canister, disposable, used with suction pump, each |
157 |
142 |
$2K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
96 |
65 |
$2K |
| K0006 |
Heavy duty wheelchair |
33 |
32 |
$2K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
29 |
28 |
$2K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
101 |
89 |
$1K |
| A7002 |
Tubing, used with suction pump, each |
150 |
131 |
$1K |
| B9998 |
Noc for enteral supplies |
63 |
52 |
$1K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
113 |
112 |
$1K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
54 |
52 |
$1K |
| L3260 |
Surgical boot/shoe, each |
41 |
41 |
$906.91 |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
13 |
12 |
$900.35 |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
15 |
15 |
$891.56 |
| E0245 |
Tub stool or bench |
32 |
31 |
$865.81 |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
14 |
13 |
$854.84 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
72 |
64 |
$848.61 |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
31 |
24 |
$826.54 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
20 |
13 |
$779.63 |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
12 |
12 |
$359.10 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
56 |
55 |
$199.69 |
| A7015 |
Aerosol mask, used with dme nebulizer |
66 |
65 |
$106.83 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
31 |
27 |
$52.25 |