| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,578 |
716 |
$503K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
15,609 |
11,891 |
$465K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,005 |
586 |
$365K |
| A7030 |
Full face mask used with positive airway pressure device, each |
5,998 |
4,679 |
$258K |
| E0601 |
Continuous positive airway pressure (cpap) device |
9,974 |
5,592 |
$161K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
6,989 |
5,611 |
$137K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
998 |
666 |
$134K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
4,314 |
3,454 |
$109K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
1,258 |
867 |
$90K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
8,586 |
4,832 |
$78K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
428 |
191 |
$74K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,683 |
3,593 |
$71K |
| A7035 |
Headgear used with positive airway pressure device |
6,467 |
5,070 |
$63K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,090 |
6,274 |
$58K |
| A7526 |
Tracheostomy tube collar/holder, each |
920 |
588 |
$40K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,560 |
2,126 |
$39K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
1,757 |
1,087 |
$38K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
2,371 |
1,205 |
$37K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
12,968 |
10,071 |
$29K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
4,449 |
3,637 |
$29K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,530 |
1,113 |
$26K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
647 |
316 |
$25K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,499 |
720 |
$24K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
355 |
282 |
$21K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
504 |
341 |
$19K |
| E0570 |
Nebulizer, with compressor |
5,569 |
3,586 |
$18K |
| 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) |
588 |
333 |
$18K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
322 |
149 |
$17K |
| A7037 |
Tubing used with positive airway pressure device |
3,229 |
2,426 |
$17K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,079 |
935 |
$15K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
791 |
636 |
$13K |
| A4217 |
Sterile water/saline, 500 ml |
680 |
411 |
$13K |
| E1392 |
Portable oxygen concentrator, rental |
1,181 |
768 |
$13K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,077 |
778 |
$12K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
909 |
735 |
$11K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
2,545 |
2,002 |
$9K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
139 |
86 |
$7K |
| A4452 |
Tape, waterproof, per 18 square inches |
435 |
373 |
$6K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,114 |
820 |
$4K |
| A7002 |
Tubing, used with suction pump, each |
1,097 |
768 |
$4K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
37 |
25 |
$4K |
| 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 |
170 |
125 |
$3K |
| K0001 |
Standard wheelchair |
719 |
618 |
$3K |
| A4927 |
Gloves, non-sterile, per 100 |
433 |
249 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,303 |
983 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
70 |
65 |
$3K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
109 |
90 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
670 |
542 |
$2K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
331 |
275 |
$1K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
30 |
28 |
$869.66 |
| A7525 |
Tracheostomy mask, each |
222 |
154 |
$528.52 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
144 |
130 |
$495.52 |
| A7015 |
Aerosol mask, used with dme nebulizer |
188 |
152 |
$215.12 |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
410 |
274 |
$205.80 |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
49 |
41 |
$203.45 |
| E1399 |
Durable medical equipment, miscellaneous |
30 |
21 |
$0.00 |