| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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) |
3,073 |
2,015 |
$789K |
| A7030 |
Full face mask used with positive airway pressure device, each |
8,139 |
5,747 |
$655K |
| E0601 |
Continuous positive airway pressure (cpap) device |
5,791 |
3,896 |
$563K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
16,780 |
12,280 |
$488K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
9,138 |
6,823 |
$483K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
2,428 |
2,070 |
$398K |
| A7031 |
Face mask interface, replacement for full face mask, each |
10,196 |
7,469 |
$375K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
7,966 |
6,171 |
$356K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,288 |
2,466 |
$351K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,020 |
3,429 |
$327K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
2,023 |
1,119 |
$313K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,606 |
2,146 |
$297K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
6,633 |
4,588 |
$255K |
| A7035 |
Headgear used with positive airway pressure device |
10,749 |
7,628 |
$183K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,003 |
1,069 |
$159K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
23,426 |
17,577 |
$152K |
| A4927 |
Gloves, non-sterile, per 100 |
6,775 |
3,764 |
$108K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
3,303 |
1,867 |
$105K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
3,529 |
2,669 |
$105K |
| T4541 |
Incontinence product, disposable underpad, large, each |
4,546 |
2,995 |
$97K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,201 |
761 |
$90K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
2,192 |
973 |
$77K |
| E0570 |
Nebulizer, with compressor |
2,634 |
1,858 |
$68K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,963 |
1,488 |
$59K |
| K0001 |
Standard wheelchair |
4,082 |
2,173 |
$56K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,017 |
499 |
$40K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
561 |
341 |
$40K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,548 |
2,431 |
$40K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
4,620 |
3,643 |
$38K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
659 |
274 |
$28K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
288 |
238 |
$27K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
682 |
234 |
$24K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
165 |
117 |
$16K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
456 |
386 |
$8K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
345 |
232 |
$6K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
88 |
71 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
524 |
187 |
$5K |
| A7036 |
Chinstrap used with positive airway pressure device |
574 |
470 |
$5K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
47 |
40 |
$4K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
817 |
479 |
$4K |
| 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 |
47 |
37 |
$3K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
50 |
26 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
134 |
112 |
$2K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
35 |
27 |
$1K |
| A4452 |
Tape, waterproof, per 18 square inches |
93 |
63 |
$747.84 |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
15 |
12 |
$630.27 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
42 |
27 |
$569.77 |
| E0156 |
Seat attachment, walker |
41 |
26 |
$307.10 |