| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
14,837 |
14,701 |
$741K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
6,118 |
5,718 |
$627K |
| 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) |
3,453 |
3,422 |
$426K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,988 |
3,924 |
$341K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,455 |
3,412 |
$254K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,146 |
1,134 |
$246K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
5,762 |
5,687 |
$237K |
| K0001 |
Standard wheelchair |
6,312 |
6,167 |
$212K |
| 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) |
589 |
582 |
$196K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,208 |
3,156 |
$184K |
| E0570 |
Nebulizer, with compressor |
2,432 |
2,421 |
$175K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
2,498 |
2,477 |
$174K |
| E0277 |
Powered pressure-reducing air mattress |
522 |
507 |
$153K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
3,095 |
2,873 |
$145K |
| A7035 |
Headgear used with positive airway pressure device |
6,511 |
6,405 |
$129K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
1,141 |
1,124 |
$124K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
12,290 |
12,127 |
$123K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
6,657 |
1,768 |
$120K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,299 |
1,290 |
$114K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
394 |
259 |
$111K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,082 |
3,023 |
$109K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,288 |
2,128 |
$101K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
964 |
950 |
$87K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,327 |
1,302 |
$59K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,825 |
2,551 |
$54K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
954 |
529 |
$54K |
| K0007 |
Extra heavy duty wheelchair |
447 |
447 |
$45K |
| K0003 |
Lightweight wheelchair |
1,005 |
1,002 |
$44K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,942 |
3,888 |
$43K |
| 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 |
982 |
547 |
$42K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
367 |
367 |
$39K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
61 |
36 |
$37K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,819 |
1,793 |
$36K |
| K0006 |
Heavy duty wheelchair |
504 |
504 |
$35K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
829 |
828 |
$33K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
535 |
532 |
$25K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,367 |
1,298 |
$25K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,350 |
1,247 |
$23K |
| E0271 |
Mattress, innerspring |
1,272 |
1,267 |
$19K |
| A7037 |
Tubing used with positive airway pressure device |
875 |
852 |
$17K |
| E0305 |
Bed side rails, half length |
1,773 |
1,759 |
$17K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
394 |
247 |
$17K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,066 |
1,061 |
$16K |
| A7002 |
Tubing, used with suction pump, each |
1,629 |
1,604 |
$16K |
| E0156 |
Seat attachment, walker |
1,383 |
1,363 |
$16K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
329 |
270 |
$16K |
| A7504 |
Filter for use in a tracheostoma heat and moisture exchange system, each |
242 |
242 |
$12K |
| L0637 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
15 |
15 |
$11K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
188 |
162 |
$10K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
41 |
25 |
$10K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
524 |
455 |
$6K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
379 |
346 |
$6K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
323 |
323 |
$6K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
891 |
812 |
$5K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
150 |
146 |
$4K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
323 |
323 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,469 |
1,463 |
$3K |
| A7525 |
Tracheostomy mask, each |
445 |
443 |
$3K |
| L4397 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf |
17 |
12 |
$2K |
| A7036 |
Chinstrap used with positive airway pressure device |
196 |
194 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
199 |
199 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
866 |
863 |
$1K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
25 |
25 |
$1K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
13 |
13 |
$1K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
181 |
181 |
$834.06 |
| A7012 |
Water collection device, used with large volume nebulizer |
119 |
117 |
$719.80 |
| E0245 |
Tub stool or bench |
13 |
12 |
$419.76 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
24 |
24 |
$224.20 |
| A4332 |
Lubricant, individual sterile packet, each |
40 |
40 |
$33.75 |