| 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 |
46,970 |
35,743 |
$1.65M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,540 |
1,292 |
$577K |
| E0601 |
Continuous positive airway pressure (cpap) device |
8,925 |
7,081 |
$307K |
| A7030 |
Full face mask used with positive airway pressure device, each |
5,247 |
4,005 |
$275K |
| A7031 |
Face mask interface, replacement for full face mask, each |
7,963 |
6,386 |
$234K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,618 |
1,392 |
$176K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
4,220 |
3,361 |
$150K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
11,294 |
9,079 |
$142K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
18,803 |
14,452 |
$139K |
| E1150 |
Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests |
2,295 |
1,926 |
$135K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,820 |
2,939 |
$120K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
3,402 |
2,833 |
$108K |
| 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 |
6,493 |
4,922 |
$96K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,044 |
739 |
$92K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,429 |
2,693 |
$89K |
| E0570 |
Nebulizer, with compressor |
11,087 |
8,501 |
$89K |
| 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) |
955 |
762 |
$80K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
104 |
75 |
$69K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
2,578 |
2,098 |
$67K |
| E1392 |
Portable oxygen concentrator, rental |
6,943 |
5,370 |
$66K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,091 |
768 |
$65K |
| A7035 |
Headgear used with positive airway pressure device |
5,491 |
4,267 |
$61K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
2,256 |
1,775 |
$54K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
701 |
516 |
$53K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
14,797 |
11,913 |
$51K |
| A7037 |
Tubing used with positive airway pressure device |
6,025 |
4,557 |
$47K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,022 |
1,456 |
$31K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
4,969 |
3,617 |
$31K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,371 |
1,024 |
$27K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
2,169 |
1,715 |
$24K |
| E1130 |
Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests |
775 |
644 |
$23K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
582 |
324 |
$22K |
| A4623 |
Tracheostomy, inner cannula |
153 |
99 |
$13K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
694 |
545 |
$10K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
273 |
204 |
$9K |
| E0156 |
Seat attachment, walker |
673 |
507 |
$6K |
| E1140 |
Wheelchair, detachable arms, desk or full length, swing away detachable footrests |
95 |
87 |
$5K |
| A7002 |
Tubing, used with suction pump, each |
602 |
452 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
517 |
418 |
$5K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
117 |
94 |
$5K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
476 |
341 |
$3K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
116 |
115 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,121 |
2,323 |
$3K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
287 |
185 |
$2K |
| K0001 |
Standard wheelchair |
1,502 |
1,302 |
$2K |
| E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
57 |
40 |
$1K |
| A7525 |
Tracheostomy mask, each |
1,106 |
576 |
$1K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
118 |
100 |
$1K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
30 |
25 |
$675.73 |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,006 |
791 |
$659.63 |
| A4618 |
Breathing circuits |
63 |
24 |
$636.86 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
158 |
117 |
$499.92 |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
14 |
12 |
$402.60 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
427 |
364 |
$351.28 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
102 |
53 |
$290.09 |
| A7036 |
Chinstrap used with positive airway pressure device |
30 |
27 |
$252.54 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
501 |
414 |
$180.73 |
| E0442 |
Stationary oxygen contents, liquid, 1 month's supply = 1 unit |
64 |
62 |
$45.40 |