| 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 |
9,908 |
8,732 |
$607K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,224 |
2,796 |
$107K |
| E0570 |
Nebulizer, with compressor |
1,989 |
1,750 |
$59K |
| 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 |
2,645 |
2,296 |
$57K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 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 |
184 |
162 |
$41K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,465 |
3,003 |
$40K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
1,073 |
864 |
$40K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
371 |
323 |
$39K |
| K0001 |
Standard wheelchair |
2,604 |
2,181 |
$39K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,525 |
1,257 |
$36K |
| E1392 |
Portable oxygen concentrator, rental |
1,706 |
1,463 |
$34K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,983 |
1,660 |
$33K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
262 |
221 |
$29K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
549 |
467 |
$22K |
| A7030 |
Full face mask used with positive airway pressure device, each |
294 |
238 |
$17K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
349 |
290 |
$13K |
| A7035 |
Headgear used with positive airway pressure device |
779 |
630 |
$11K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,636 |
1,348 |
$10K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
33 |
25 |
$7K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
228 |
177 |
$6K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
140 |
120 |
$6K |
| A7031 |
Face mask interface, replacement for full face mask, each |
132 |
111 |
$5K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
144 |
117 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
350 |
277 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
548 |
471 |
$2K |
| B9998 |
Noc for enteral supplies |
66 |
49 |
$2K |
| A4335 |
Incontinence supply; miscellaneous |
152 |
125 |
$2K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
16 |
13 |
$1K |
| A5120 |
Skin barrier, wipes or swabs, each |
137 |
96 |
$934.39 |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
79 |
55 |
$428.22 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
14 |
13 |
$376.88 |
| E0776 |
Iv pole |
12 |
12 |
$79.68 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
12 |
12 |
$67.85 |