| 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 |
10,868 |
10,375 |
$578K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,584 |
4,452 |
$229K |
| 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 |
5,904 |
5,619 |
$190K |
| 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) |
1,498 |
1,452 |
$161K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
1,652 |
1,495 |
$159K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
7,044 |
6,832 |
$118K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,391 |
2,130 |
$109K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,215 |
1,140 |
$90K |
| K0001 |
Standard wheelchair |
2,784 |
2,602 |
$81K |
| E0570 |
Nebulizer, with compressor |
2,427 |
2,279 |
$79K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,160 |
1,095 |
$73K |
| A7035 |
Headgear used with positive airway pressure device |
1,691 |
1,592 |
$35K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,152 |
1,090 |
$33K |
| K0003 |
Lightweight wheelchair |
580 |
556 |
$31K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,151 |
1,103 |
$26K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
615 |
589 |
$25K |
| A7037 |
Tubing used with positive airway pressure device |
1,509 |
1,448 |
$24K |
| 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) |
90 |
86 |
$22K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,475 |
1,403 |
$18K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
472 |
321 |
$15K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
298 |
255 |
$15K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
375 |
314 |
$14K |
| E1392 |
Portable oxygen concentrator, rental |
523 |
493 |
$14K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
296 |
270 |
$8K |
| E0202 |
Phototherapy (bilirubin) light with photometer |
44 |
37 |
$8K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
992 |
949 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,163 |
2,072 |
$5K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
368 |
356 |
$5K |
| L8000 |
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type |
236 |
210 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
314 |
296 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
154 |
144 |
$2K |
| L8030 |
Breast prosthesis, silicone or equal, without integral adhesive |
18 |
14 |
$2K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
1,073 |
558 |
$621.69 |
| E0245 |
Tub stool or bench |
14 |
12 |
$418.50 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
324 |
310 |
$262.64 |
| A7015 |
Aerosol mask, used with dme nebulizer |
201 |
198 |
$218.08 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
33 |
25 |
$60.13 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
96 |
92 |
$1.96 |