| 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 |
32,345 |
28,710 |
$1.44M |
| E0601 |
Continuous positive airway pressure (cpap) device |
8,994 |
8,047 |
$332K |
| E0570 |
Nebulizer, with compressor |
6,751 |
5,796 |
$273K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
358 |
244 |
$214K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
20,456 |
18,047 |
$201K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,702 |
2,373 |
$137K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
723 |
551 |
$129K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
737 |
587 |
$110K |
| 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) |
1,255 |
1,078 |
$105K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
9,484 |
8,408 |
$102K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,699 |
2,276 |
$90K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,524 |
3,099 |
$89K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
146 |
98 |
$74K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
627 |
471 |
$73K |
| E1392 |
Portable oxygen concentrator, rental |
3,105 |
2,676 |
$54K |
| K0001 |
Standard wheelchair |
3,821 |
3,145 |
$48K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
423 |
333 |
$47K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,134 |
1,049 |
$39K |
| A7037 |
Tubing used with positive airway pressure device |
3,946 |
3,516 |
$38K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
202 |
134 |
$38K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
776 |
714 |
$37K |
| A7035 |
Headgear used with positive airway pressure device |
2,839 |
2,533 |
$37K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
304 |
262 |
$33K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
783 |
578 |
$32K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
372 |
291 |
$32K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
1,014 |
984 |
$31K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
243 |
231 |
$27K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
626 |
551 |
$24K |
| B9002 |
Enteral nutrition infusion pump, any type |
293 |
263 |
$23K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,536 |
2,295 |
$23K |
| A7526 |
Tracheostomy tube collar/holder, each |
499 |
395 |
$21K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
6,136 |
5,456 |
$19K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
480 |
443 |
$16K |
| E1399 |
Durable medical equipment, miscellaneous |
171 |
111 |
$15K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
440 |
320 |
$15K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
466 |
405 |
$13K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
201 |
156 |
$13K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
365 |
321 |
$11K |
| K0003 |
Lightweight wheelchair |
378 |
347 |
$10K |
| A7000 |
Canister, disposable, used with suction pump, each |
805 |
638 |
$10K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
295 |
266 |
$9K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,139 |
1,006 |
$9K |
| K0007 |
Extra heavy duty wheelchair |
141 |
132 |
$8K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
777 |
624 |
$8K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
486 |
309 |
$8K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
811 |
737 |
$6K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
73 |
52 |
$6K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,215 |
1,112 |
$6K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
194 |
180 |
$6K |
| A7002 |
Tubing, used with suction pump, each |
840 |
646 |
$4K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
299 |
235 |
$4K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
145 |
118 |
$4K |
| E0776 |
Iv pole |
323 |
291 |
$3K |
| K0006 |
Heavy duty wheelchair |
67 |
60 |
$2K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
741 |
400 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
855 |
766 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
195 |
171 |
$2K |
| E0156 |
Seat attachment, walker |
238 |
203 |
$2K |
| A4623 |
Tracheostomy, inner cannula |
15 |
12 |
$2K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
160 |
110 |
$2K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
16 |
14 |
$1K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
411 |
236 |
$964.99 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
41 |
38 |
$434.26 |
| A7036 |
Chinstrap used with positive airway pressure device |
47 |
38 |
$352.54 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
833 |
748 |
$240.59 |