| 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 |
14,806 |
14,761 |
$1.07M |
| E0601 |
Continuous positive airway pressure (cpap) device |
12,044 |
12,033 |
$618K |
| 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) |
2,039 |
2,032 |
$197K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
10,800 |
10,762 |
$159K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
4,276 |
4,256 |
$147K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
13,214 |
13,193 |
$131K |
| E0570 |
Nebulizer, with compressor |
4,171 |
4,160 |
$114K |
| K0001 |
Standard wheelchair |
6,026 |
6,004 |
$111K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,146 |
3,121 |
$105K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,092 |
2,071 |
$105K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,333 |
1,323 |
$61K |
| A7035 |
Headgear used with positive airway pressure device |
3,751 |
3,720 |
$58K |
| A7037 |
Tubing used with positive airway pressure device |
2,636 |
2,627 |
$52K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,305 |
1,305 |
$36K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
6,280 |
6,236 |
$35K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,505 |
1,491 |
$34K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,179 |
1,168 |
$25K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,208 |
2,198 |
$18K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,164 |
3,140 |
$15K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,071 |
1,065 |
$15K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
506 |
499 |
$12K |
| A4670 |
Automatic blood pressure monitor |
161 |
159 |
$9K |
| E1392 |
Portable oxygen concentrator, rental |
942 |
940 |
$8K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,488 |
1,481 |
$7K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,100 |
1,078 |
$7K |
| K0006 |
Heavy duty wheelchair |
162 |
161 |
$5K |
| A4452 |
Tape, waterproof, per 18 square inches |
108 |
105 |
$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) |
12 |
12 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
246 |
154 |
$2K |
| E0156 |
Seat attachment, walker |
233 |
233 |
$2K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
249 |
247 |
$1K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
27 |
26 |
$1K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
44 |
41 |
$710.78 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
293 |
165 |
$614.32 |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
41 |
40 |
$613.99 |
| A7015 |
Aerosol mask, used with dme nebulizer |
302 |
302 |
$315.39 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
184 |
183 |
$272.04 |
| A7036 |
Chinstrap used with positive airway pressure device |
24 |
24 |
$171.94 |