| 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 |
11,310 |
9,745 |
$320K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
408 |
317 |
$113K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
730 |
571 |
$74K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
581 |
513 |
$53K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
146 |
110 |
$45K |
| E1392 |
Portable oxygen concentrator, rental |
4,644 |
4,162 |
$45K |
| 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 |
4,336 |
3,872 |
$43K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,928 |
1,495 |
$41K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,058 |
726 |
$27K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,459 |
1,097 |
$25K |
| K0003 |
Lightweight wheelchair |
1,450 |
1,083 |
$23K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
435 |
333 |
$20K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,006 |
659 |
$17K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
905 |
778 |
$16K |
| E0570 |
Nebulizer, with compressor |
1,451 |
1,241 |
$15K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 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 |
379 |
263 |
$15K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,223 |
893 |
$13K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
639 |
526 |
$12K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
284 |
199 |
$11K |
| A7526 |
Tracheostomy tube collar/holder, each |
367 |
287 |
$10K |
| A7031 |
Face mask interface, replacement for full face mask, each |
957 |
669 |
$10K |
| B9002 |
Enteral nutrition infusion pump, any type |
199 |
176 |
$9K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,812 |
1,429 |
$8K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
392 |
287 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
1,064 |
747 |
$7K |
| A7000 |
Canister, disposable, used with suction pump, each |
663 |
516 |
$6K |
| K0001 |
Standard wheelchair |
821 |
631 |
$6K |
| A4623 |
Tracheostomy, inner cannula |
88 |
63 |
$5K |
| 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) |
32 |
24 |
$3K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
225 |
154 |
$3K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
140 |
88 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
119 |
114 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,738 |
1,197 |
$2K |
| A7002 |
Tubing, used with suction pump, each |
540 |
416 |
$2K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
403 |
331 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
423 |
294 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
738 |
632 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
48 |
32 |
$517.65 |
| E0156 |
Seat attachment, walker |
94 |
78 |
$354.36 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
24 |
13 |
$229.46 |
| A7015 |
Aerosol mask, used with dme nebulizer |
152 |
130 |
$94.09 |
| E1399 |
Durable medical equipment, miscellaneous |
62 |
36 |
$64.00 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
198 |
167 |
$41.33 |
| A7525 |
Tracheostomy mask, each |
13 |
12 |
$15.08 |