| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
19,401 |
16,542 |
$493K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
7,834 |
6,735 |
$336K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,753 |
3,393 |
$210K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,892 |
1,409 |
$192K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,627 |
3,854 |
$186K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
4,962 |
4,493 |
$176K |
| E0619 |
Apnea monitor, with recording feature |
773 |
696 |
$146K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,864 |
1,426 |
$105K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,456 |
3,978 |
$102K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
4,569 |
4,177 |
$95K |
| 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) |
1,865 |
1,497 |
$92K |
| A7035 |
Headgear used with positive airway pressure device |
6,323 |
5,718 |
$74K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,983 |
5,986 |
$68K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,816 |
2,536 |
$65K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
1,662 |
1,267 |
$59K |
| B9998 |
Noc for enteral supplies |
1,972 |
1,178 |
$48K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
375 |
290 |
$43K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
249 |
213 |
$38K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
183 |
120 |
$36K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
12,975 |
11,705 |
$35K |
| A7037 |
Tubing used with positive airway pressure device |
3,211 |
2,930 |
$30K |
| B9002 |
Enteral nutrition infusion pump, any type |
613 |
482 |
$25K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
175 |
125 |
$22K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
95 |
63 |
$22K |
| K0003 |
Lightweight wheelchair |
876 |
762 |
$21K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
927 |
778 |
$21K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
5,050 |
4,596 |
$20K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
707 |
588 |
$18K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,051 |
971 |
$18K |
| A7526 |
Tracheostomy tube collar/holder, each |
390 |
290 |
$17K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,285 |
1,086 |
$16K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,161 |
909 |
$14K |
| E0570 |
Nebulizer, with compressor |
511 |
461 |
$14K |
| A4927 |
Gloves, non-sterile, per 100 |
1,269 |
965 |
$10K |
| A7002 |
Tubing, used with suction pump, each |
1,359 |
1,120 |
$8K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,129 |
995 |
$8K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
356 |
330 |
$7K |
| A4657 |
Syringe, with or without needle, each |
753 |
520 |
$6K |
| 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 |
72 |
62 |
$4K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
529 |
454 |
$4K |
| E1392 |
Portable oxygen concentrator, rental |
216 |
178 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
81 |
79 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,158 |
930 |
$2K |
| E0776 |
Iv pole |
287 |
197 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
257 |
192 |
$1K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
17 |
13 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
774 |
670 |
$1K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
22 |
15 |
$854.75 |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
226 |
172 |
$379.59 |
| E1399 |
Durable medical equipment, miscellaneous |
39 |
27 |
$362.48 |
| A7036 |
Chinstrap used with positive airway pressure device |
50 |
46 |
$357.49 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
44 |
36 |
$300.67 |
| A4557 |
Lead wires, (e.g., apnea monitor), per pair |
27 |
12 |
$265.13 |
| A7509 |
Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each |
27 |
13 |
$219.38 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
30 |
26 |
$101.08 |
| A7525 |
Tracheostomy mask, each |
20 |
12 |
$38.19 |