| 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 |
9,587 |
8,854 |
$565K |
| 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) |
1,204 |
1,151 |
$430K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,465 |
4,165 |
$326K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,808 |
2,609 |
$267K |
| 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) |
1,274 |
1,172 |
$180K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,643 |
4,355 |
$170K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,370 |
2,234 |
$152K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
947 |
897 |
$152K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,481 |
1,429 |
$142K |
| E0570 |
Nebulizer, with compressor |
4,193 |
3,738 |
$109K |
| A7035 |
Headgear used with positive airway pressure device |
4,476 |
4,228 |
$103K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,548 |
2,457 |
$92K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,570 |
2,344 |
$91K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,163 |
2,041 |
$87K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,020 |
6,486 |
$78K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
951 |
932 |
$74K |
| A4927 |
Gloves, non-sterile, per 100 |
6,635 |
5,763 |
$71K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,875 |
1,806 |
$71K |
| K0001 |
Standard wheelchair |
4,627 |
3,951 |
$69K |
| E0294 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress |
1,768 |
1,752 |
$62K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,584 |
7,162 |
$52K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,318 |
1,154 |
$50K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
524 |
499 |
$49K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
275 |
265 |
$48K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,328 |
1,226 |
$37K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,822 |
2,675 |
$33K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,364 |
1,281 |
$28K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
2,213 |
2,094 |
$20K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
503 |
425 |
$18K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
166 |
146 |
$17K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
1,354 |
1,018 |
$14K |
| A7000 |
Canister, disposable, used with suction pump, each |
438 |
415 |
$12K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
171 |
161 |
$12K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
738 |
688 |
$7K |
| E1392 |
Portable oxygen concentrator, rental |
487 |
426 |
$6K |
| A7002 |
Tubing, used with suction pump, each |
416 |
360 |
$5K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
54 |
54 |
$5K |
| E0156 |
Seat attachment, walker |
386 |
338 |
$4K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
42 |
41 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
276 |
243 |
$3K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
134 |
116 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
61 |
53 |
$2K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
25 |
24 |
$2K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
199 |
143 |
$1K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
12 |
12 |
$775.60 |
| A7526 |
Tracheostomy tube collar/holder, each |
13 |
12 |
$558.09 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
12 |
12 |
$491.78 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
25 |
25 |
$490.32 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
213 |
209 |
$284.91 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
13 |
12 |
$195.98 |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
14 |
13 |
$45.10 |
| A7015 |
Aerosol mask, used with dme nebulizer |
14 |
14 |
$19.65 |