| 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 |
46,690 |
38,678 |
$2.03M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
4,079 |
3,431 |
$1.25M |
| E0601 |
Continuous positive airway pressure (cpap) device |
11,272 |
10,163 |
$953K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,965 |
4,342 |
$380K |
| A7030 |
Full face mask used with positive airway pressure device, each |
6,134 |
5,058 |
$359K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
8,721 |
7,483 |
$357K |
| 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) |
3,163 |
2,692 |
$346K |
| K0001 |
Standard wheelchair |
13,709 |
12,356 |
$292K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
8,197 |
6,799 |
$275K |
| 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 |
18,432 |
15,546 |
$245K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,645 |
1,250 |
$211K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
8,514 |
7,335 |
$210K |
| 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) |
1,192 |
1,040 |
$209K |
| E0570 |
Nebulizer, with compressor |
3,697 |
3,254 |
$178K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,944 |
4,060 |
$178K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
3,539 |
2,998 |
$177K |
| A7035 |
Headgear used with positive airway pressure device |
10,693 |
9,162 |
$145K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,372 |
2,869 |
$144K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
13,445 |
11,513 |
$115K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
3,823 |
2,845 |
$101K |
| K0007 |
Extra heavy duty wheelchair |
1,455 |
1,263 |
$100K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
333 |
189 |
$99K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
410 |
345 |
$97K |
| A7037 |
Tubing used with positive airway pressure device |
6,950 |
5,932 |
$89K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
9,088 |
7,821 |
$86K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,996 |
1,665 |
$80K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
1,338 |
1,158 |
$78K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
688 |
512 |
$77K |
| E1392 |
Portable oxygen concentrator, rental |
4,314 |
3,559 |
$55K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
1,196 |
966 |
$54K |
| B9998 |
Noc for enteral supplies |
850 |
686 |
$51K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
5,903 |
5,089 |
$41K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
942 |
702 |
$36K |
| E0604 |
Breast pump, hospital grade, electric (ac and / or dc), any type |
1,078 |
998 |
$33K |
| K0003 |
Lightweight wheelchair |
1,227 |
1,106 |
$32K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,354 |
1,183 |
$31K |
| E0294 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress |
538 |
500 |
$29K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,692 |
1,487 |
$27K |
| B9002 |
Enteral nutrition infusion pump, any type |
908 |
786 |
$23K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
385 |
310 |
$18K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
2,120 |
1,841 |
$18K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
152 |
136 |
$16K |
| E0184 |
Dry pressure mattress |
1,473 |
1,307 |
$14K |
| E0156 |
Seat attachment, walker |
1,333 |
1,123 |
$12K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,459 |
1,110 |
$9K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
844 |
570 |
$8K |
| E0776 |
Iv pole |
621 |
573 |
$8K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,546 |
1,359 |
$8K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
126 |
121 |
$7K |
| A7036 |
Chinstrap used with positive airway pressure device |
1,025 |
889 |
$6K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
861 |
781 |
$6K |
| E1399 |
Durable medical equipment, miscellaneous |
32 |
24 |
$4K |
| A7526 |
Tracheostomy tube collar/holder, each |
130 |
89 |
$4K |
| A4623 |
Tracheostomy, inner cannula |
32 |
26 |
$2K |
| A7000 |
Canister, disposable, used with suction pump, each |
78 |
50 |
$2K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
98 |
67 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,767 |
1,549 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
43 |
25 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
656 |
608 |
$857.75 |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
15 |
13 |
$746.83 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
1,402 |
1,241 |
$681.58 |
| K0006 |
Heavy duty wheelchair |
12 |
12 |
$658.00 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
14 |
12 |
$283.69 |
| E0266 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress |
65 |
54 |
$59.48 |
| A4452 |
Tape, waterproof, per 18 square inches |
12 |
12 |
$47.27 |