| 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 |
18,393 |
16,150 |
$746K |
| E0570 |
Nebulizer, with compressor |
39,354 |
35,040 |
$406K |
| E0601 |
Continuous positive airway pressure (cpap) device |
10,650 |
9,245 |
$253K |
| A7030 |
Full face mask used with positive airway pressure device, each |
4,790 |
4,097 |
$227K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
4,780 |
4,205 |
$127K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
13,801 |
12,083 |
$112K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
4,061 |
3,604 |
$102K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,984 |
1,585 |
$94K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,324 |
3,712 |
$84K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
907 |
666 |
$77K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,971 |
2,430 |
$73K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
2,121 |
1,805 |
$65K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,013 |
1,643 |
$62K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,817 |
1,568 |
$49K |
| A7037 |
Tubing used with positive airway pressure device |
3,157 |
2,740 |
$47K |
| K0001 |
Standard wheelchair |
6,695 |
5,887 |
$46K |
| A7035 |
Headgear used with positive airway pressure device |
4,994 |
4,195 |
$43K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,374 |
3,624 |
$42K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,850 |
1,576 |
$41K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,978 |
6,611 |
$38K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
436 |
359 |
$37K |
| 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) |
687 |
569 |
$33K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
587 |
429 |
$33K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
53 |
39 |
$30K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
347 |
307 |
$28K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
196 |
156 |
$24K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,303 |
1,072 |
$23K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
506 |
406 |
$21K |
| A4259 |
Lancets, per box of 100 |
3,456 |
3,077 |
$17K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,951 |
2,449 |
$16K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
128 |
114 |
$14K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
337 |
237 |
$11K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
636 |
505 |
$8K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
328 |
273 |
$8K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
247 |
222 |
$6K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
589 |
516 |
$6K |
| E0156 |
Seat attachment, walker |
820 |
683 |
$4K |
| B9998 |
Noc for enteral supplies |
219 |
90 |
$3K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
26 |
24 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,063 |
931 |
$2K |
| S8490 |
Insulin syringes (100 syringes, any size) |
112 |
92 |
$2K |
| A4554 |
Disposable underpads, all sizes |
31 |
30 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
213 |
135 |
$2K |
| A4245 |
Alcohol wipes, per box |
900 |
782 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
443 |
400 |
$1K |
| E1392 |
Portable oxygen concentrator, rental |
344 |
316 |
$1K |
| A7000 |
Canister, disposable, used with suction pump, each |
128 |
91 |
$1K |
| A4335 |
Incontinence supply; miscellaneous |
222 |
140 |
$904.21 |
| K0006 |
Heavy duty wheelchair |
51 |
49 |
$727.73 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
27 |
24 |
$566.76 |
| K0007 |
Extra heavy duty wheelchair |
13 |
12 |
$257.76 |
| A7036 |
Chinstrap used with positive airway pressure device |
27 |
25 |
$123.01 |
| K0003 |
Lightweight wheelchair |
12 |
12 |
$108.02 |