| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
13,702 |
11,783 |
$959K |
| 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) |
3,812 |
3,202 |
$578K |
| E0570 |
Nebulizer, with compressor |
13,226 |
12,358 |
$534K |
| A7031 |
Face mask interface, replacement for full face mask, each |
10,626 |
9,643 |
$401K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
2,723 |
2,243 |
$373K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,940 |
3,658 |
$350K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,386 |
4,792 |
$302K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
15,169 |
14,014 |
$264K |
| A7037 |
Tubing used with positive airway pressure device |
8,069 |
7,559 |
$172K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,074 |
2,831 |
$127K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,762 |
2,529 |
$124K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
17,979 |
16,579 |
$118K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,991 |
1,846 |
$118K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,823 |
2,642 |
$117K |
| A7035 |
Headgear used with positive airway pressure device |
5,724 |
5,215 |
$110K |
| K0001 |
Standard wheelchair |
7,068 |
6,422 |
$107K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
2,236 |
2,131 |
$84K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
362 |
305 |
$33K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
892 |
842 |
$27K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,312 |
2,952 |
$26K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,396 |
2,152 |
$24K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,228 |
3,777 |
$18K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
906 |
808 |
$16K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
471 |
449 |
$10K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
329 |
216 |
$10K |
| K0003 |
Lightweight wheelchair |
353 |
327 |
$9K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
73 |
64 |
$9K |
| K0007 |
Extra heavy duty wheelchair |
208 |
193 |
$8K |
| E0156 |
Seat attachment, walker |
1,335 |
1,266 |
$7K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,187 |
1,073 |
$6K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
466 |
369 |
$6K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
79 |
76 |
$5K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
156 |
154 |
$4K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
327 |
216 |
$4K |
| A7036 |
Chinstrap used with positive airway pressure device |
412 |
388 |
$4K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,365 |
663 |
$3K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
221 |
201 |
$3K |
| K0006 |
Heavy duty wheelchair |
72 |
68 |
$2K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
26 |
12 |
$1K |
| L8000 |
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type |
61 |
38 |
$950.14 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
224 |
214 |
$634.53 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
13 |
13 |
$427.08 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
22 |
13 |
$402.27 |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
51 |
50 |
$382.92 |