| 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 |
37,506 |
32,787 |
$1.57M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
4,025 |
3,415 |
$1.15M |
| E0601 |
Continuous positive airway pressure (cpap) device |
21,102 |
18,597 |
$691K |
| A7030 |
Full face mask used with positive airway pressure device, each |
10,265 |
8,341 |
$510K |
| 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) |
6,605 |
5,734 |
$482K |
| A7031 |
Face mask interface, replacement for full face mask, each |
13,529 |
10,431 |
$256K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
7,414 |
6,062 |
$246K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
18,324 |
16,076 |
$242K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
24,032 |
20,991 |
$235K |
| K0003 |
Lightweight wheelchair |
11,529 |
10,087 |
$234K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
9,645 |
7,955 |
$219K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
916 |
724 |
$203K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
7,546 |
6,342 |
$154K |
| A7035 |
Headgear used with positive airway pressure device |
11,382 |
9,515 |
$131K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
5,487 |
4,210 |
$96K |
| E0570 |
Nebulizer, with compressor |
7,609 |
6,428 |
$86K |
| A7037 |
Tubing used with positive airway pressure device |
8,250 |
6,718 |
$77K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
506 |
411 |
$72K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,470 |
2,142 |
$58K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
7,517 |
6,180 |
$55K |
| K0001 |
Standard wheelchair |
4,963 |
4,286 |
$52K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
2,950 |
2,333 |
$52K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
21,036 |
16,391 |
$47K |
| K0007 |
Extra heavy duty wheelchair |
1,050 |
924 |
$40K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
333 |
142 |
$37K |
| 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 |
2,833 |
2,529 |
$33K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
476 |
385 |
$32K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,527 |
1,232 |
$32K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,844 |
1,796 |
$29K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
4,074 |
3,502 |
$23K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,451 |
1,182 |
$22K |
| E1392 |
Portable oxygen concentrator, rental |
1,958 |
1,711 |
$22K |
| K0006 |
Heavy duty wheelchair |
524 |
484 |
$22K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
1,067 |
831 |
$16K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
284 |
225 |
$11K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
437 |
383 |
$11K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
382 |
331 |
$9K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
2,211 |
1,882 |
$7K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
44 |
12 |
$6K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
368 |
304 |
$5K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
712 |
581 |
$5K |
| A7000 |
Canister, disposable, used with suction pump, each |
682 |
544 |
$5K |
| A7526 |
Tracheostomy tube collar/holder, each |
374 |
297 |
$5K |
| E0483 |
High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each |
26 |
25 |
$4K |
| A4623 |
Tracheostomy, inner cannula |
80 |
53 |
$4K |
| A7002 |
Tubing, used with suction pump, each |
1,422 |
636 |
$4K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
316 |
219 |
$4K |
| E0156 |
Seat attachment, walker |
469 |
406 |
$3K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
87 |
63 |
$3K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
476 |
398 |
$3K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
28 |
25 |
$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 |
67 |
48 |
$2K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
46 |
38 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,861 |
1,618 |
$2K |
| 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) |
14 |
12 |
$2K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
130 |
90 |
$1K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
271 |
214 |
$1K |
| E0277 |
Powered pressure-reducing air mattress |
41 |
25 |
$1K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
70 |
58 |
$882.81 |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
79 |
61 |
$760.45 |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
15 |
14 |
$639.00 |
| T4541 |
Incontinence product, disposable underpad, large, each |
16 |
15 |
$462.00 |
| E0168 |
Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each |
16 |
16 |
$434.36 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
21 |
19 |
$400.00 |
| E0271 |
Mattress, innerspring |
108 |
92 |
$385.83 |
| E1020 |
Residual limb support system for wheelchair, any type |
16 |
12 |
$240.74 |
| A7036 |
Chinstrap used with positive airway pressure device |
42 |
38 |
$235.58 |
| A4927 |
Gloves, non-sterile, per 100 |
19 |
19 |
$225.94 |
| A7525 |
Tracheostomy mask, each |
91 |
74 |
$77.72 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
33 |
28 |
$14.03 |
| A7015 |
Aerosol mask, used with dme nebulizer |
24 |
18 |
$13.73 |