| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,162 |
1,944 |
$1.15M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
21,292 |
18,633 |
$1.01M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
15,016 |
13,162 |
$183K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,926 |
2,431 |
$116K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,552 |
1,210 |
$91K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,587 |
1,126 |
$58K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
455 |
313 |
$54K |
| K0001 |
Standard wheelchair |
2,145 |
1,927 |
$35K |
| A7037 |
Tubing used with positive airway pressure device |
2,510 |
1,903 |
$33K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
336 |
286 |
$24K |
| A7035 |
Headgear used with positive airway pressure device |
1,820 |
1,436 |
$21K |
| E0570 |
Nebulizer, with compressor |
2,015 |
1,814 |
$20K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,255 |
990 |
$19K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
64 |
41 |
$19K |
| A7031 |
Face mask interface, replacement for full face mask, each |
878 |
724 |
$18K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,967 |
1,469 |
$17K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,193 |
3,232 |
$15K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
652 |
532 |
$14K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
357 |
310 |
$9K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,360 |
1,229 |
$9K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
322 |
279 |
$9K |
| A4452 |
Tape, waterproof, per 18 square inches |
482 |
358 |
$8K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
210 |
147 |
$8K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
149 |
130 |
$6K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
289 |
242 |
$6K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
161 |
127 |
$6K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
279 |
198 |
$6K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
51 |
39 |
$3K |
| E0156 |
Seat attachment, walker |
395 |
347 |
$3K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
59 |
41 |
$3K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
469 |
351 |
$2K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
123 |
114 |
$1K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
20 |
16 |
$1K |
| A7000 |
Canister, disposable, used with suction pump, each |
30 |
26 |
$530.64 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
31 |
24 |
$305.30 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
60 |
38 |
$188.44 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
88 |
75 |
$138.05 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
15 |
14 |
$49.13 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
16 |
12 |
$46.33 |
| E0159 |
Brake attachment for wheeled walker, replacement, each |
26 |
25 |
$33.66 |