| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
21,198 |
19,153 |
$397K |
| A7030 |
Full face mask used with positive airway pressure device, each |
7,430 |
6,727 |
$267K |
| A7031 |
Face mask interface, replacement for full face mask, each |
9,650 |
8,858 |
$199K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
8,070 |
7,419 |
$176K |
| T4541 |
Incontinence product, disposable underpad, large, each |
3,875 |
3,506 |
$167K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,290 |
1,178 |
$163K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,828 |
4,471 |
$159K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
7,038 |
6,503 |
$152K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,452 |
4,733 |
$136K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
884 |
824 |
$121K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
8,222 |
7,466 |
$116K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,762 |
1,607 |
$97K |
| A7035 |
Headgear used with positive airway pressure device |
9,312 |
8,547 |
$95K |
| A4927 |
Gloves, non-sterile, per 100 |
4,143 |
3,665 |
$87K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
21,120 |
19,088 |
$81K |
| 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) |
2,256 |
1,991 |
$65K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
3,253 |
3,007 |
$56K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
389 |
354 |
$51K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,964 |
2,711 |
$44K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,695 |
2,420 |
$39K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,626 |
1,107 |
$32K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
5,120 |
4,717 |
$24K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
48 |
48 |
$22K |
| A7037 |
Tubing used with positive airway pressure device |
3,755 |
3,415 |
$22K |
| E1392 |
Portable oxygen concentrator, rental |
1,467 |
1,319 |
$21K |
| A7036 |
Chinstrap used with positive airway pressure device |
795 |
741 |
$10K |
| 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) |
85 |
79 |
$8K |
| E0570 |
Nebulizer, with compressor |
1,275 |
1,169 |
$7K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
316 |
281 |
$6K |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
546 |
469 |
$5K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
33 |
24 |
$5K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
888 |
562 |
$4K |
| A4553 |
Non-disposable underpads, all sizes |
237 |
232 |
$4K |
| B9002 |
Enteral nutrition infusion pump, any type |
310 |
282 |
$2K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
203 |
156 |
$2K |
| K0001 |
Standard wheelchair |
83 |
76 |
$1K |
| E0776 |
Iv pole |
698 |
605 |
$1K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
55 |
49 |
$722.07 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
30 |
29 |
$38.83 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
28 |
27 |
$13.91 |