| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
2,872 |
2,842 |
$363K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,534 |
2,519 |
$250K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,088 |
2,076 |
$44K |
| E0570 |
Nebulizer, with compressor |
805 |
802 |
$28K |
| A6403 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing |
664 |
486 |
$9K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
845 |
592 |
$9K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
143 |
141 |
$8K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
212 |
212 |
$4K |
| E0601 |
Continuous positive airway pressure (cpap) device |
46 |
46 |
$4K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
937 |
702 |
$3K |
| A6260 |
Wound cleansers, any type, any size |
433 |
399 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
16 |
16 |
$1K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
51 |
51 |
$706.51 |
| A7037 |
Tubing used with positive airway pressure device |
45 |
45 |
$647.27 |
| A7035 |
Headgear used with positive airway pressure device |
12 |
12 |
$296.00 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
82 |
81 |
$264.93 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
12 |
12 |
$90.82 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
12 |
12 |
$84.50 |
| A7015 |
Aerosol mask, used with dme nebulizer |
25 |
25 |
$25.89 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
12 |
12 |
$19.36 |