| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer, with compressor |
5,652 |
5,638 |
$523K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,320 |
4,295 |
$406K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
963 |
956 |
$257K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,656 |
1,652 |
$188K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
6,292 |
6,284 |
$100K |
| K0001 |
Standard wheelchair |
3,903 |
3,841 |
$85K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,407 |
4,264 |
$83K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,606 |
1,575 |
$65K |
| E0601 |
Continuous positive airway pressure (cpap) device |
909 |
907 |
$47K |
| K0003 |
Lightweight wheelchair |
1,031 |
1,028 |
$46K |
| E0135 |
Walker, folding (pickup), adjustable or fixed height |
1,042 |
1,026 |
$44K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,595 |
2,552 |
$24K |
| B9002 |
Enteral nutrition infusion pump, any type |
322 |
322 |
$18K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
547 |
296 |
$11K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
996 |
994 |
$10K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
383 |
378 |
$8K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
130 |
124 |
$8K |
| A7015 |
Aerosol mask, used with dme nebulizer |
6,293 |
6,267 |
$7K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
41 |
36 |
$6K |
| E0776 |
Iv pole |
726 |
722 |
$6K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
67 |
66 |
$3K |
| A7526 |
Tracheostomy tube collar/holder, each |
180 |
177 |
$3K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
112 |
107 |
$2K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
160 |
157 |
$2K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
30 |
28 |
$2K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
25 |
25 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
87 |
84 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
27 |
27 |
$908.30 |
| A7037 |
Tubing used with positive airway pressure device |
27 |
27 |
$861.98 |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
26 |
26 |
$859.51 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
66 |
66 |
$515.93 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
40 |
40 |
$373.15 |
| A7000 |
Canister, disposable, used with suction pump, each |
12 |
12 |
$64.03 |
| A7002 |
Tubing, used with suction pump, each |
36 |
36 |
$62.72 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
12 |
12 |
$26.66 |