| 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 |
5,071 |
5,059 |
$245K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,208 |
3,196 |
$108K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,475 |
1,473 |
$102K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
132 |
127 |
$70K |
| E0570 |
Nebulizer, with compressor |
2,001 |
2,000 |
$37K |
| A7037 |
Tubing used with positive airway pressure device |
2,215 |
2,208 |
$28K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
978 |
974 |
$23K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
476 |
472 |
$21K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,496 |
2,488 |
$20K |
| A7035 |
Headgear used with positive airway pressure device |
1,365 |
1,359 |
$19K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
205 |
203 |
$16K |
| 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 |
703 |
701 |
$13K |
| K0001 |
Standard wheelchair |
655 |
653 |
$10K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
296 |
296 |
$9K |
| T4541 |
Incontinence product, disposable underpad, large, each |
267 |
266 |
$8K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,574 |
2,565 |
$7K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
194 |
190 |
$6K |
| A7031 |
Face mask interface, replacement for full face mask, each |
177 |
177 |
$4K |
| 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) |
39 |
39 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
88 |
88 |
$1K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
330 |
317 |
$954.83 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
97 |
97 |
$680.11 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
88 |
88 |
$85.82 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
27 |
27 |
$47.93 |