| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,187 |
650 |
$814K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
6,598 |
6,365 |
$464K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,792 |
3,647 |
$285K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,697 |
2,571 |
$255K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,221 |
4,048 |
$152K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
746 |
719 |
$127K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,787 |
1,716 |
$115K |
| A7035 |
Headgear used with positive airway pressure device |
3,736 |
3,598 |
$88K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
836 |
784 |
$76K |
| A4217 |
Sterile water/saline, 500 ml |
889 |
664 |
$76K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,480 |
2,342 |
$73K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
1,020 |
899 |
$64K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,718 |
1,659 |
$63K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,480 |
3,290 |
$50K |
| A4927 |
Gloves, non-sterile, per 100 |
4,324 |
3,616 |
$49K |
| 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) |
426 |
413 |
$45K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,976 |
5,651 |
$43K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,082 |
1,037 |
$41K |
| A7526 |
Tracheostomy tube collar/holder, each |
537 |
387 |
$40K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,991 |
2,812 |
$33K |
| A4605 |
Tracheal suction catheter, closed system, each |
204 |
151 |
$31K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,244 |
1,157 |
$31K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
665 |
513 |
$26K |
| E1392 |
Portable oxygen concentrator, rental |
1,276 |
1,243 |
$24K |
| A7002 |
Tubing, used with suction pump, each |
1,458 |
1,223 |
$19K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
658 |
612 |
$17K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
387 |
346 |
$16K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
678 |
596 |
$14K |
| E0570 |
Nebulizer, with compressor |
459 |
378 |
$10K |
| A4618 |
Breathing circuits |
546 |
477 |
$8K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
84 |
79 |
$7K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
623 |
494 |
$6K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
677 |
640 |
$5K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
154 |
142 |
$3K |
| 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) |
12 |
12 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
662 |
604 |
$2K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
15 |
12 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
217 |
200 |
$1K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
12 |
12 |
$1K |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
112 |
92 |
$394.18 |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
19 |
12 |
$156.99 |
| A7036 |
Chinstrap used with positive airway pressure device |
13 |
12 |
$112.64 |