| 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 |
9,153 |
8,613 |
$450K |
| A7030 |
Full face mask used with positive airway pressure device, each |
596 |
584 |
$58K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,304 |
1,208 |
$58K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,991 |
3,745 |
$33K |
| E1392 |
Portable oxygen concentrator, rental |
2,877 |
2,700 |
$32K |
| E0570 |
Nebulizer, with compressor |
3,465 |
3,365 |
$32K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
894 |
878 |
$28K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
696 |
651 |
$27K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
350 |
350 |
$26K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
258 |
256 |
$24K |
| K0001 |
Standard wheelchair |
1,666 |
1,601 |
$19K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
123 |
116 |
$19K |
| A7031 |
Face mask interface, replacement for full face mask, each |
488 |
477 |
$19K |
| T4541 |
Incontinence product, disposable underpad, large, each |
882 |
854 |
$15K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
567 |
517 |
$13K |
| A7035 |
Headgear used with positive airway pressure device |
558 |
544 |
$10K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
154 |
152 |
$9K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
67 |
67 |
$9K |
| A4927 |
Gloves, non-sterile, per 100 |
807 |
769 |
$7K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
220 |
220 |
$6K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
282 |
277 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,175 |
1,133 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
105 |
102 |
$5K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
31 |
31 |
$4K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
51 |
51 |
$4K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
39 |
39 |
$4K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
26 |
26 |
$3K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
25 |
25 |
$2K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
14 |
13 |
$2K |
| A7000 |
Canister, disposable, used with suction pump, each |
26 |
25 |
$633.37 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
79 |
75 |
$574.39 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
14 |
13 |
$564.89 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
15 |
13 |
$538.23 |
| E0156 |
Seat attachment, walker |
41 |
40 |
$446.97 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
13 |
13 |
$421.78 |
| A7002 |
Tubing, used with suction pump, each |
27 |
26 |
$185.64 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
14 |
12 |
$79.30 |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
36 |
36 |
$78.48 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
62 |
62 |
$62.33 |