| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1392 |
Portable oxygen concentrator, rental |
9,559 |
8,104 |
$384K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
674 |
631 |
$128K |
| E2402 |
Negative pressure wound therapy electrical pump, stationary or portable |
26 |
24 |
$35K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
32,687 |
31,866 |
$18K |
| K0001 |
Standard wheelchair |
31,740 |
30,749 |
$15K |
| E0570 |
Nebulizer, with compressor |
35,373 |
34,904 |
$11K |
| E0601 |
Continuous positive airway pressure (cpap) device |
32,973 |
32,215 |
$9K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
30 |
24 |
$7K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
38,864 |
37,954 |
$6K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
9,242 |
8,919 |
$6K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
18,525 |
17,673 |
$4K |
| K0003 |
Lightweight wheelchair |
6,314 |
6,089 |
$4K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
10,185 |
8,203 |
$4K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
6,862 |
6,556 |
$3K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
7,536 |
4,235 |
$3K |
| 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) |
5,170 |
5,043 |
$2K |
| A4615 |
Cannula, nasal |
5,558 |
3,981 |
$2K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
7,116 |
5,982 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,584 |
3,471 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
2,975 |
2,856 |
$2K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
2,674 |
2,619 |
$1K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
3,225 |
3,119 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,590 |
5,358 |
$1K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
3,282 |
3,206 |
$1K |
| E0277 |
Powered pressure-reducing air mattress |
1,744 |
1,714 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,507 |
2,399 |
$1K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,233 |
2,165 |
$1K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
2,053 |
2,036 |
$1K |
| E0635 |
Patient lift, electric with seat or sling |
2,205 |
2,114 |
$1K |
| K0006 |
Heavy duty wheelchair |
2,187 |
2,148 |
$915.20 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
1,755 |
1,728 |
$846.82 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
8,853 |
8,604 |
$770.67 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
7,266 |
5,909 |
$766.05 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,782 |
1,708 |
$761.00 |
| A7037 |
Tubing used with positive airway pressure device |
5,214 |
5,035 |
$679.12 |
| E0156 |
Seat attachment, walker |
3,663 |
3,553 |
$608.08 |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
1,525 |
1,258 |
$601.01 |
| A7035 |
Headgear used with positive airway pressure device |
2,991 |
2,916 |
$597.24 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
1,425 |
1,354 |
$531.17 |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,315 |
1,238 |
$526.00 |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
1,237 |
1,226 |
$507.55 |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
1,275 |
1,190 |
$489.89 |
| A6022 |
Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each |
1,174 |
885 |
$459.35 |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
1,030 |
961 |
$435.47 |
| 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) |
690 |
673 |
$407.50 |
| A7015 |
Aerosol mask, used with dme nebulizer |
18,488 |
17,649 |
$389.50 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
2,612 |
2,396 |
$379.99 |
| K0800 |
Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds |
629 |
601 |
$358.45 |
| A5120 |
Skin barrier, wipes or swabs, each |
3,266 |
3,037 |
$350.39 |
| E1353 |
Regulator |
2,029 |
1,821 |
$349.59 |
| A7000 |
Canister, disposable, used with suction pump, each |
1,094 |
934 |
$312.73 |
| E0619 |
Apnea monitor, with recording feature |
638 |
619 |
$262.30 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
3,726 |
3,074 |
$237.80 |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
489 |
470 |
$235.21 |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
1,652 |
1,513 |
$225.00 |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
430 |
418 |
$216.28 |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
538 |
487 |
$192.21 |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
1,295 |
1,084 |
$190.49 |
| A4927 |
Gloves, non-sterile, per 100 |
857 |
777 |
$183.18 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
693 |
628 |
$155.36 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
356 |
343 |
$146.63 |
| A4452 |
Tape, waterproof, per 18 square inches |
1,615 |
1,306 |
$143.46 |
| E0135 |
Walker, folding (pickup), adjustable or fixed height |
379 |
358 |
$138.89 |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
356 |
345 |
$134.16 |
| A4371 |
Ostomy skin barrier, powder, per oz |
889 |
839 |
$133.41 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
876 |
837 |
$131.05 |
| 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 |
1,084 |
871 |
$116.53 |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
163 |
159 |
$109.99 |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
1,128 |
1,045 |
$109.06 |
| K0005 |
Ultralightweight wheelchair |
57 |
50 |
$108.83 |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
241 |
236 |
$107.24 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
2,190 |
1,998 |
$105.96 |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
676 |
646 |
$96.32 |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
518 |
427 |
$75.68 |
| E0202 |
Phototherapy (bilirubin) light with photometer |
157 |
36 |
$66.22 |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
17 |
12 |
$66.02 |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
193 |
182 |
$62.78 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
341 |
292 |
$59.33 |
| A4456 |
Adhesive remover, wipes, any type, each |
1,988 |
1,863 |
$56.17 |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
1,180 |
1,089 |
$55.58 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
772 |
711 |
$54.67 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
174 |
161 |
$48.59 |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
120 |
114 |
$48.59 |
| A4311 |
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
105 |
103 |
$44.29 |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
110 |
102 |
$43.70 |
| A6223 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing |
419 |
364 |
$42.84 |
| E1031 |
Rollabout chair, any and all types with casters 5" or greater |
13 |
12 |
$42.74 |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
338 |
287 |
$39.67 |
| E0621 |
Sling or seat, patient lift, canvas or nylon |
172 |
168 |
$38.27 |
| A7526 |
Tracheostomy tube collar/holder, each |
210 |
168 |
$36.34 |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
203 |
196 |
$29.24 |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
369 |
325 |
$22.22 |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
216 |
207 |
$20.91 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
43 |
41 |
$16.77 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
53 |
49 |
$16.02 |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
32 |
25 |
$13.76 |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
303 |
285 |
$13.01 |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
67 |
62 |
$12.90 |
| A6447 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard |
503 |
464 |
$10.75 |
| A7002 |
Tubing, used with suction pump, each |
102 |
99 |
$9.30 |
| A6210 |
Foam 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 |
30 |
27 |
$6.88 |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
57 |
50 |
$6.45 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
27 |
26 |
$5.59 |
| K0007 |
Extra heavy duty wheelchair |
12 |
12 |
$5.16 |
| E0618 |
Apnea monitor, without recording feature |
12 |
12 |
$5.16 |
| A4616 |
Tubing (oxygen), per foot |
16 |
13 |
$5.16 |
| A4670 |
Automatic blood pressure monitor |
13 |
12 |
$5.16 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
12 |
12 |
$2.58 |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
12 |
12 |
$1.72 |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
28 |
24 |
$1.29 |
| A4402 |
Lubricant, per ounce |
42 |
37 |
$1.29 |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
16 |
15 |
$0.86 |