| 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 |
14,181 |
12,545 |
$673K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
748 |
663 |
$569K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,929 |
4,424 |
$152K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,385 |
3,097 |
$147K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,126 |
1,934 |
$140K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,857 |
4,413 |
$139K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
1,169 |
993 |
$92K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,768 |
6,950 |
$85K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
5,770 |
5,228 |
$64K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,795 |
2,376 |
$61K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,077 |
1,805 |
$52K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,903 |
1,775 |
$48K |
| A4927 |
Gloves, non-sterile, per 100 |
1,950 |
1,676 |
$48K |
| A7035 |
Headgear used with positive airway pressure device |
3,042 |
2,764 |
$43K |
| K0001 |
Standard wheelchair |
2,230 |
1,965 |
$40K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
903 |
741 |
$39K |
| E1392 |
Portable oxygen concentrator, rental |
2,572 |
2,204 |
$35K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
8,465 |
7,517 |
$32K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
712 |
613 |
$28K |
| E0570 |
Nebulizer, with compressor |
4,638 |
4,296 |
$27K |
| 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) |
321 |
293 |
$21K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,069 |
1,876 |
$18K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
370 |
353 |
$17K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
126 |
106 |
$16K |
| T4541 |
Incontinence product, disposable underpad, large, each |
297 |
272 |
$13K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
2,718 |
2,452 |
$13K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
2,262 |
1,048 |
$11K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
156 |
143 |
$11K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
69 |
62 |
$9K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,418 |
1,271 |
$8K |
| A7000 |
Canister, disposable, used with suction pump, each |
336 |
298 |
$7K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
689 |
579 |
$6K |
| K0007 |
Extra heavy duty wheelchair |
93 |
80 |
$6K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
85 |
72 |
$5K |
| A7036 |
Chinstrap used with positive airway pressure device |
559 |
501 |
$4K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
52 |
48 |
$4K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
466 |
389 |
$4K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
361 |
314 |
$3K |
| A7002 |
Tubing, used with suction pump, each |
223 |
198 |
$2K |
| A7526 |
Tracheostomy tube collar/holder, each |
26 |
24 |
$2K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
13 |
12 |
$1K |
| E1020 |
Residual limb support system for wheelchair, any type |
61 |
51 |
$1K |
| E0156 |
Seat attachment, walker |
442 |
361 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
261 |
229 |
$657.50 |
| A7037 |
Tubing used with positive airway pressure device |
43 |
43 |
$621.82 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
25 |
24 |
$227.34 |
| A4371 |
Ostomy skin barrier, powder, per oz |
43 |
37 |
$159.28 |