| 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 |
18,933 |
15,465 |
$1.19M |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,711 |
1,330 |
$1.03M |
| E0601 |
Continuous positive airway pressure (cpap) device |
9,722 |
8,515 |
$469K |
| A7030 |
Full face mask used with positive airway pressure device, each |
5,867 |
5,012 |
$458K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
15,166 |
10,695 |
$420K |
| K0001 |
Standard wheelchair |
22,819 |
16,639 |
$397K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
5,598 |
5,004 |
$314K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
9,432 |
8,136 |
$280K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,224 |
2,814 |
$223K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,264 |
1,205 |
$216K |
| 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) |
2,507 |
2,042 |
$210K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,373 |
1,278 |
$202K |
| A7031 |
Face mask interface, replacement for full face mask, each |
5,482 |
4,684 |
$186K |
| 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) |
871 |
737 |
$166K |
| A4217 |
Sterile water/saline, 500 ml |
2,037 |
1,406 |
$157K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,949 |
3,304 |
$155K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
3,243 |
2,864 |
$130K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,936 |
9,502 |
$129K |
| A7035 |
Headgear used with positive airway pressure device |
7,364 |
6,444 |
$128K |
| K0007 |
Extra heavy duty wheelchair |
2,103 |
1,469 |
$120K |
| E0570 |
Nebulizer, with compressor |
7,113 |
5,279 |
$120K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
4,685 |
3,321 |
$119K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,579 |
1,304 |
$107K |
| E0277 |
Powered pressure-reducing air mattress |
736 |
567 |
$95K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
1,116 |
893 |
$93K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
1,690 |
1,344 |
$87K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
963 |
759 |
$83K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
5,872 |
4,075 |
$78K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
3,658 |
2,995 |
$77K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
7,831 |
6,032 |
$75K |
| A4670 |
Automatic blood pressure monitor |
1,645 |
1,493 |
$75K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
12,873 |
11,299 |
$74K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,092 |
919 |
$71K |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
1,039 |
734 |
$66K |
| E1392 |
Portable oxygen concentrator, rental |
4,142 |
3,340 |
$65K |
| T4541 |
Incontinence product, disposable underpad, large, each |
3,811 |
3,187 |
$63K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
2,008 |
1,824 |
$59K |
| A4927 |
Gloves, non-sterile, per 100 |
5,032 |
3,763 |
$58K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,380 |
1,007 |
$56K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,247 |
1,053 |
$55K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
683 |
516 |
$54K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
4,772 |
4,197 |
$47K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
536 |
455 |
$43K |
| A7000 |
Canister, disposable, used with suction pump, each |
2,315 |
1,905 |
$42K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
573 |
428 |
$42K |
| A4623 |
Tracheostomy, inner cannula |
495 |
341 |
$40K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,659 |
920 |
$36K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
346 |
279 |
$34K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
479 |
374 |
$28K |
| E0156 |
Seat attachment, walker |
3,043 |
2,593 |
$27K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
393 |
272 |
$25K |
| K0006 |
Heavy duty wheelchair |
537 |
381 |
$24K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
311 |
253 |
$23K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,392 |
1,193 |
$22K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
745 |
499 |
$22K |
| A4605 |
Tracheal suction catheter, closed system, each |
301 |
217 |
$22K |
| E1399 |
Durable medical equipment, miscellaneous |
119 |
70 |
$20K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
6,328 |
3,053 |
$18K |
| A7002 |
Tubing, used with suction pump, each |
2,411 |
1,955 |
$17K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
1,239 |
795 |
$15K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
136 |
118 |
$14K |
| K0003 |
Lightweight wheelchair |
470 |
389 |
$14K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
67 |
64 |
$14K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,841 |
1,663 |
$13K |
| A7037 |
Tubing used with positive airway pressure device |
654 |
596 |
$12K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,952 |
1,407 |
$11K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,005 |
579 |
$9K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
132 |
119 |
$9K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
1,341 |
927 |
$9K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
198 |
154 |
$8K |
| A4618 |
Breathing circuits |
484 |
342 |
$8K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
345 |
225 |
$8K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
2,242 |
1,963 |
$7K |
| K0004 |
High strength, lightweight wheelchair |
214 |
151 |
$7K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
667 |
565 |
$7K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
429 |
298 |
$6K |
| E2202 |
Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches |
285 |
198 |
$5K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
61 |
50 |
$4K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
34 |
14 |
$4K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
28 |
24 |
$4K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
446 |
338 |
$4K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
90 |
76 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,519 |
1,325 |
$3K |
| E1372 |
Immersion external heater for nebulizer |
219 |
164 |
$2K |
| A7036 |
Chinstrap used with positive airway pressure device |
291 |
243 |
$2K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
1,608 |
746 |
$2K |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
794 |
663 |
$2K |
| E0966 |
Manual wheelchair accessory, headrest extension, each |
482 |
400 |
$2K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
476 |
323 |
$2K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
141 |
90 |
$2K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
36 |
25 |
$2K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
18 |
13 |
$1K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
15 |
12 |
$821.84 |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
142 |
103 |
$573.32 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
32 |
25 |
$541.55 |
| E0244 |
Raised toilet seat |
34 |
25 |
$446.46 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
41 |
37 |
$303.25 |
| E0197 |
Air pressure pad for mattress, standard mattress length and width |
82 |
64 |
$276.75 |
| A7012 |
Water collection device, used with large volume nebulizer |
41 |
36 |
$160.66 |
| A7525 |
Tracheostomy mask, each |
46 |
38 |
$106.14 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
13 |
12 |
$51.18 |
| E1355 |
Stand/rack |
23 |
12 |
$20.00 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
486 |
287 |
$0.00 |