| 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 |
16,698 |
14,490 |
$1.21M |
| E0601 |
Continuous positive airway pressure (cpap) device |
14,997 |
14,086 |
$898K |
| A7030 |
Full face mask used with positive airway pressure device, each |
5,730 |
5,140 |
$516K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
9,201 |
8,228 |
$299K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
9,878 |
9,476 |
$283K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
4,341 |
3,891 |
$259K |
| 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) |
986 |
893 |
$245K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,251 |
1,179 |
$220K |
| A7031 |
Face mask interface, replacement for full face mask, each |
5,287 |
4,674 |
$172K |
| A7035 |
Headgear used with positive airway pressure device |
6,374 |
5,729 |
$124K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
3,269 |
2,923 |
$115K |
| 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) |
1,128 |
1,021 |
$115K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,319 |
1,211 |
$114K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,424 |
7,167 |
$103K |
| K0001 |
Standard wheelchair |
5,021 |
4,270 |
$83K |
| E1392 |
Portable oxygen concentrator, rental |
4,211 |
3,650 |
$67K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
12,416 |
11,176 |
$67K |
| E0570 |
Nebulizer, with compressor |
3,913 |
3,329 |
$66K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
852 |
746 |
$65K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,381 |
2,006 |
$54K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
662 |
575 |
$51K |
| A4927 |
Gloves, non-sterile, per 100 |
3,337 |
2,585 |
$40K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,250 |
1,916 |
$39K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,945 |
3,499 |
$35K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
624 |
571 |
$32K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,025 |
904 |
$24K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
829 |
517 |
$16K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,431 |
1,291 |
$14K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
514 |
463 |
$9K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
311 |
249 |
$6K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
124 |
105 |
$4K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
214 |
167 |
$3K |
| K0004 |
High strength, lightweight wheelchair |
25 |
24 |
$2K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
27 |
21 |
$1K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
63 |
54 |
$1K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
19 |
12 |
$843.36 |
| E0156 |
Seat attachment, walker |
15 |
14 |
$85.42 |
| A7015 |
Aerosol mask, used with dme nebulizer |
66 |
61 |
$61.77 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
14 |
12 |
$49.68 |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
65 |
64 |
$0.00 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
183 |
118 |
$0.00 |