| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
3,697 |
2,101 |
$1.86M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
4,027 |
2,565 |
$1.60M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
28,831 |
20,245 |
$1.38M |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
5,906 |
3,725 |
$514K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
2,146 |
1,067 |
$249K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
2,383 |
1,291 |
$173K |
| 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 |
6,700 |
4,270 |
$161K |
| A4623 |
Tracheostomy, inner cannula |
2,025 |
1,054 |
$133K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
2,804 |
1,394 |
$117K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
16,856 |
12,372 |
$110K |
| A7526 |
Tracheostomy tube collar/holder, each |
3,003 |
1,563 |
$91K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,357 |
2,525 |
$70K |
| A4217 |
Sterile water/saline, 500 ml |
3,386 |
1,356 |
$67K |
| E1399 |
Durable medical equipment, miscellaneous |
865 |
359 |
$66K |
| E0570 |
Nebulizer, with compressor |
4,882 |
3,459 |
$63K |
| A7000 |
Canister, disposable, used with suction pump, each |
4,042 |
2,215 |
$56K |
| K0001 |
Standard wheelchair |
6,403 |
4,512 |
$55K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,526 |
1,146 |
$47K |
| L8501 |
Tracheostomy speaking valve |
1,230 |
647 |
$43K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,381 |
717 |
$38K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,385 |
1,121 |
$34K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,901 |
1,366 |
$32K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
930 |
527 |
$27K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,024 |
800 |
$21K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
876 |
640 |
$18K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
2,870 |
1,499 |
$15K |
| A7035 |
Headgear used with positive airway pressure device |
1,860 |
1,368 |
$14K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,193 |
880 |
$14K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
866 |
676 |
$13K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,529 |
1,750 |
$11K |
| A7002 |
Tubing, used with suction pump, each |
3,980 |
2,158 |
$10K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
396 |
246 |
$10K |
| A7037 |
Tubing used with positive airway pressure device |
1,173 |
849 |
$9K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,243 |
2,435 |
$7K |
| 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) |
114 |
86 |
$7K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
718 |
429 |
$6K |
| E0619 |
Apnea monitor, with recording feature |
64 |
44 |
$5K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
972 |
739 |
$5K |
| E1392 |
Portable oxygen concentrator, rental |
692 |
517 |
$5K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
296 |
147 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
202 |
153 |
$3K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
3,055 |
1,665 |
$3K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,006 |
464 |
$3K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
1,306 |
661 |
$3K |
| A4402 |
Lubricant, per ounce |
1,235 |
628 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,368 |
1,373 |
$2K |
| A7012 |
Water collection device, used with large volume nebulizer |
1,249 |
623 |
$2K |
| A7525 |
Tracheostomy mask, each |
1,859 |
888 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
96 |
74 |
$1K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
40 |
27 |
$976.38 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
525 |
393 |
$958.83 |
| A7015 |
Aerosol mask, used with dme nebulizer |
719 |
421 |
$606.33 |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
34 |
25 |
$478.57 |
| E0156 |
Seat attachment, walker |
115 |
91 |
$466.90 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
244 |
194 |
$324.44 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
583 |
313 |
$160.44 |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
233 |
161 |
$64.31 |
| W4047 |
|
279 |
102 |
$0.00 |