| 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 |
5,749 |
5,593 |
$402K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,081 |
1,983 |
$144K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,262 |
1,207 |
$81K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
396 |
375 |
$55K |
| E0570 |
Nebulizer, with compressor |
2,482 |
2,385 |
$53K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
986 |
950 |
$46K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,298 |
3,174 |
$43K |
| K0001 |
Standard wheelchair |
1,089 |
1,061 |
$41K |
| A7030 |
Full face mask used with positive airway pressure device, each |
431 |
420 |
$38K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
213 |
209 |
$36K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,284 |
1,261 |
$34K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
731 |
669 |
$33K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,245 |
1,194 |
$28K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
812 |
784 |
$23K |
| A7035 |
Headgear used with positive airway pressure device |
673 |
652 |
$12K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
53 |
51 |
$8K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
290 |
278 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,669 |
1,608 |
$6K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
58 |
53 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,355 |
1,246 |
$3K |
| 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 |
159 |
155 |
$3K |
| A4927 |
Gloves, non-sterile, per 100 |
160 |
148 |
$2K |
| K0006 |
Heavy duty wheelchair |
88 |
85 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
66 |
64 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
36 |
36 |
$367.59 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
308 |
304 |
$214.86 |
| A7015 |
Aerosol mask, used with dme nebulizer |
210 |
195 |
$172.30 |
| E0156 |
Seat attachment, walker |
14 |
14 |
$143.49 |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
138 |
138 |
$142.95 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
12 |
12 |
$58.57 |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
56 |
56 |
$0.00 |