| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
12,232 |
11,630 |
$602K |
| A7030 |
Full face mask used with positive airway pressure device, each |
4,817 |
4,483 |
$450K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
9,459 |
8,815 |
$437K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,630 |
2,511 |
$399K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
5,146 |
4,892 |
$342K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
8,901 |
8,390 |
$329K |
| A7035 |
Headgear used with positive airway pressure device |
8,215 |
7,800 |
$193K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,415 |
3,114 |
$117K |
| E0294 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress |
3,778 |
3,711 |
$98K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
12,571 |
11,888 |
$89K |
| K0001 |
Standard wheelchair |
7,864 |
7,147 |
$89K |
| 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) |
953 |
882 |
$81K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
871 |
833 |
$81K |
| 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 |
4,322 |
4,002 |
$81K |
| E0570 |
Nebulizer, with compressor |
3,606 |
3,212 |
$74K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,462 |
2,280 |
$73K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
820 |
780 |
$73K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,117 |
2,008 |
$72K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
2,688 |
2,351 |
$56K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
758 |
710 |
$54K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
4,529 |
4,294 |
$53K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,256 |
1,148 |
$45K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
4,445 |
4,241 |
$40K |
| A4927 |
Gloves, non-sterile, per 100 |
3,316 |
2,819 |
$33K |
| 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) |
213 |
195 |
$30K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
307 |
285 |
$28K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,380 |
2,244 |
$27K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
954 |
877 |
$26K |
| E1392 |
Portable oxygen concentrator, rental |
1,593 |
1,478 |
$25K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
982 |
955 |
$21K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
955 |
893 |
$21K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
626 |
563 |
$20K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
58 |
38 |
$17K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,644 |
1,622 |
$16K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
867 |
604 |
$16K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
971 |
792 |
$14K |
| A7000 |
Canister, disposable, used with suction pump, each |
742 |
693 |
$11K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
237 |
231 |
$8K |
| A7002 |
Tubing, used with suction pump, each |
920 |
704 |
$7K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
882 |
788 |
$7K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
1,234 |
1,065 |
$7K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
86 |
81 |
$6K |
| E0156 |
Seat attachment, walker |
514 |
473 |
$5K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
168 |
120 |
$4K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
372 |
352 |
$4K |
| K0007 |
Extra heavy duty wheelchair |
43 |
38 |
$4K |
| A7036 |
Chinstrap used with positive airway pressure device |
349 |
329 |
$4K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
514 |
274 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
69 |
67 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
32 |
24 |
$1K |
| K0006 |
Heavy duty wheelchair |
24 |
24 |
$1K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
75 |
63 |
$342.13 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
351 |
331 |
$200.03 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
22 |
12 |
$30.38 |