| Code | Description | Claims | Beneficiaries | Total Paid |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
4,486 |
3,187 |
$2.12M |
| E0601 |
Continuous positive airway pressure (cpap) device |
17,725 |
16,878 |
$1.18M |
| A7030 |
Full face mask used with positive airway pressure device, each |
7,013 |
6,592 |
$734K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
6,576 |
6,138 |
$679K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
6,765 |
6,381 |
$449K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
11,525 |
10,845 |
$435K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
15,301 |
14,777 |
$380K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
5,023 |
1,849 |
$368K |
| 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) |
2,724 |
2,558 |
$346K |
| A7031 |
Face mask interface, replacement for full face mask, each |
8,214 |
7,645 |
$324K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,689 |
1,167 |
$312K |
| A4217 |
Sterile water/saline, 500 ml |
4,367 |
2,999 |
$303K |
| 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) |
711 |
638 |
$205K |
| A7035 |
Headgear used with positive airway pressure device |
8,902 |
8,356 |
$196K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
4,591 |
4,255 |
$172K |
| A4605 |
Tracheal suction catheter, closed system, each |
1,821 |
1,308 |
$155K |
| A7526 |
Tracheostomy tube collar/holder, each |
3,337 |
2,542 |
$132K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
16,908 |
15,900 |
$115K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
589 |
532 |
$96K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,607 |
1,001 |
$96K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,873 |
2,725 |
$93K |
| E0570 |
Nebulizer, with compressor |
6,136 |
5,938 |
$85K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
174 |
159 |
$81K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
761 |
570 |
$75K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
2,743 |
2,521 |
$74K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
674 |
549 |
$67K |
| A4623 |
Tracheostomy, inner cannula |
1,236 |
909 |
$67K |
| A7000 |
Canister, disposable, used with suction pump, each |
3,761 |
3,019 |
$64K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
6,170 |
5,798 |
$62K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
335 |
306 |
$49K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
2,235 |
1,801 |
$47K |
| A7037 |
Tubing used with positive airway pressure device |
1,268 |
1,169 |
$30K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,137 |
1,035 |
$29K |
| A4649 |
Surgical supply; miscellaneous |
743 |
562 |
$28K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,396 |
1,285 |
$27K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
477 |
327 |
$26K |
| A7002 |
Tubing, used with suction pump, each |
3,670 |
2,957 |
$26K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
2,727 |
2,561 |
$24K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
432 |
281 |
$24K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
123 |
102 |
$21K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,153 |
1,613 |
$14K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
65 |
62 |
$9K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,749 |
2,281 |
$8K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,765 |
1,326 |
$8K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,294 |
1,001 |
$8K |
| A7012 |
Water collection device, used with large volume nebulizer |
642 |
548 |
$3K |
| A7525 |
Tracheostomy mask, each |
1,042 |
724 |
$3K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
56 |
41 |
$2K |
| A5131 |
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. |
250 |
213 |
$2K |
| E1392 |
Portable oxygen concentrator, rental |
67 |
60 |
$1K |
| A4244 |
Alcohol or peroxide, per pint |
947 |
722 |
$1K |
| A7036 |
Chinstrap used with positive airway pressure device |
129 |
119 |
$1K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
478 |
406 |
$1K |
| E1399 |
Durable medical equipment, miscellaneous |
28 |
25 |
$727.95 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
211 |
184 |
$427.80 |
| A4618 |
Breathing circuits |
43 |
29 |
$418.26 |
| A7015 |
Aerosol mask, used with dme nebulizer |
14 |
12 |
$16.13 |
| A4452 |
Tape, waterproof, per 18 square inches |
15 |
12 |
$7.68 |
| A9270 |
Non-covered item or service |
57 |
39 |
$0.00 |