| 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 |
10,871 |
10,094 |
$751K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,873 |
1,486 |
$680K |
| E0601 |
Continuous positive airway pressure (cpap) device |
5,450 |
5,058 |
$316K |
| 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) |
698 |
655 |
$238K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,728 |
2,523 |
$202K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,157 |
2,064 |
$192K |
| 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) |
1,603 |
1,445 |
$192K |
| A4605 |
Tracheal suction catheter, closed system, each |
1,199 |
919 |
$180K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,873 |
4,565 |
$145K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,317 |
1,229 |
$145K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,624 |
2,479 |
$139K |
| E0570 |
Nebulizer, with compressor |
4,649 |
4,052 |
$128K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,555 |
3,289 |
$121K |
| K0001 |
Standard wheelchair |
7,575 |
6,792 |
$112K |
| A4623 |
Tracheostomy, inner cannula |
1,787 |
1,336 |
$111K |
| A4217 |
Sterile water/saline, 500 ml |
2,080 |
1,586 |
$109K |
| E0294 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress |
3,556 |
3,510 |
$100K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
1,616 |
1,291 |
$94K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,128 |
1,067 |
$92K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,496 |
6,813 |
$87K |
| A7035 |
Headgear used with positive airway pressure device |
4,531 |
4,223 |
$84K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,390 |
2,266 |
$77K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,469 |
2,267 |
$76K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
742 |
572 |
$72K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,823 |
1,633 |
$66K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
880 |
824 |
$61K |
| A4927 |
Gloves, non-sterile, per 100 |
5,909 |
4,953 |
$60K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,459 |
1,141 |
$59K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,125 |
6,740 |
$45K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,966 |
1,669 |
$44K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,547 |
1,333 |
$39K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
792 |
663 |
$38K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,266 |
1,182 |
$33K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,932 |
1,764 |
$33K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
958 |
914 |
$32K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,423 |
1,336 |
$27K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
2,178 |
1,569 |
$25K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,439 |
2,310 |
$23K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,181 |
2,134 |
$18K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,833 |
1,635 |
$16K |
| A7002 |
Tubing, used with suction pump, each |
2,265 |
1,849 |
$15K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
608 |
572 |
$14K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,747 |
1,650 |
$13K |
| E0156 |
Seat attachment, walker |
1,326 |
1,178 |
$11K |
| A4670 |
Automatic blood pressure monitor |
145 |
142 |
$7K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,525 |
1,246 |
$7K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
525 |
440 |
$7K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
847 |
726 |
$6K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
77 |
63 |
$5K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,458 |
714 |
$5K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
222 |
179 |
$4K |
| K0006 |
Heavy duty wheelchair |
56 |
55 |
$3K |
| E1392 |
Portable oxygen concentrator, rental |
184 |
179 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
62 |
48 |
$3K |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
73 |
63 |
$3K |
| E0277 |
Powered pressure-reducing air mattress |
13 |
12 |
$2K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
66 |
50 |
$2K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
15 |
15 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,016 |
938 |
$1K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
65 |
50 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
44 |
42 |
$905.66 |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
16 |
13 |
$829.34 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
226 |
208 |
$586.18 |
| E0240 |
Bath/shower chair, with or without wheels, any size |
22 |
14 |
$541.19 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
39 |
36 |
$151.22 |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
15 |
14 |
$42.01 |
| A7015 |
Aerosol mask, used with dme nebulizer |
12 |
12 |
$18.97 |