| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A7030 |
Full face mask used with positive airway pressure device, each |
4,383 |
4,156 |
$424K |
| E0601 |
Continuous positive airway pressure (cpap) device |
9,409 |
8,360 |
$386K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,632 |
4,926 |
$317K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
9,953 |
8,832 |
$223K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,986 |
1,882 |
$120K |
| A7035 |
Headgear used with positive airway pressure device |
5,311 |
5,063 |
$118K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,380 |
2,075 |
$113K |
| A7037 |
Tubing used with positive airway pressure device |
4,848 |
4,632 |
$112K |
| E0570 |
Nebulizer, with compressor |
3,554 |
3,224 |
$58K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
1,499 |
1,419 |
$51K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
8,268 |
7,830 |
$39K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,388 |
1,337 |
$36K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
217 |
201 |
$30K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,754 |
3,575 |
$27K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,652 |
1,566 |
$22K |
| E1392 |
Portable oxygen concentrator, rental |
1,286 |
1,135 |
$17K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,039 |
994 |
$7K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
99 |
96 |
$7K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
531 |
482 |
$6K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
277 |
240 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
233 |
220 |
$5K |
| K0001 |
Standard wheelchair |
477 |
411 |
$5K |
| K0002 |
Standard hemi (low seat) wheelchair |
187 |
180 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,502 |
954 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
291 |
211 |
$2K |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
208 |
126 |
$968.90 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
59 |
54 |
$938.11 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
219 |
162 |
$920.86 |
| 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) |
12 |
12 |
$733.82 |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
13 |
12 |
$445.13 |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
13 |
12 |
$264.19 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
26 |
24 |
$243.61 |
| 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 |
25 |
24 |
$228.83 |
| A7015 |
Aerosol mask, used with dme nebulizer |
152 |
148 |
$186.39 |