| 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 |
10,609 |
9,024 |
$555K |
| E0601 |
Continuous positive airway pressure (cpap) device |
8,004 |
7,228 |
$501K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,805 |
2,510 |
$234K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,700 |
3,349 |
$202K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,484 |
1,371 |
$196K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
5,764 |
5,180 |
$175K |
| A7035 |
Headgear used with positive airway pressure device |
4,961 |
4,519 |
$96K |
| E0570 |
Nebulizer, with compressor |
3,196 |
2,618 |
$61K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,982 |
1,790 |
$59K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,073 |
4,304 |
$53K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
8,141 |
7,366 |
$44K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,386 |
1,276 |
$40K |
| K0001 |
Standard wheelchair |
2,907 |
2,289 |
$38K |
| E1392 |
Portable oxygen concentrator, rental |
2,654 |
2,258 |
$34K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
59 |
36 |
$31K |
| 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) |
151 |
132 |
$29K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,091 |
2,794 |
$28K |
| 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) |
246 |
231 |
$24K |
| A4927 |
Gloves, non-sterile, per 100 |
2,664 |
2,053 |
$24K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,182 |
1,058 |
$21K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
392 |
326 |
$14K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
485 |
409 |
$8K |
| E0294 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress |
168 |
162 |
$5K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
127 |
112 |
$4K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
81 |
66 |
$4K |
| A7036 |
Chinstrap used with positive airway pressure device |
404 |
372 |
$4K |
| A7000 |
Canister, disposable, used with suction pump, each |
236 |
223 |
$4K |
| A7002 |
Tubing, used with suction pump, each |
357 |
317 |
$3K |
| A7526 |
Tracheostomy tube collar/holder, each |
43 |
37 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,607 |
1,436 |
$3K |
| T4541 |
Incontinence product, disposable underpad, large, each |
91 |
86 |
$2K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
25 |
25 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
44 |
42 |
$928.72 |
| H0020 |
Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) |
51 |
39 |
$806.31 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
122 |
84 |
$617.77 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
55 |
37 |
$613.69 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
28 |
24 |
$492.90 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
14 |
12 |
$113.98 |
| A7015 |
Aerosol mask, used with dme nebulizer |
43 |
40 |
$56.09 |