| 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 |
16,566 |
16,269 |
$1.06M |
| B4100 |
Food thickener, administered orally, per ounce |
10,388 |
10,378 |
$902K |
| E0601 |
Continuous positive airway pressure (cpap) device |
7,630 |
7,299 |
$490K |
| E0570 |
Nebulizer, with compressor |
9,440 |
9,361 |
$391K |
| A7030 |
Full face mask used with positive airway pressure device, each |
5,206 |
5,175 |
$319K |
| 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 |
3,991 |
3,479 |
$196K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,469 |
4,438 |
$177K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
4,314 |
3,875 |
$166K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,190 |
3,862 |
$162K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
6,145 |
6,079 |
$158K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
574 |
487 |
$139K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,942 |
8,769 |
$120K |
| 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) |
760 |
728 |
$92K |
| 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 |
2,253 |
1,953 |
$81K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
708 |
707 |
$71K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,619 |
1,613 |
$63K |
| A7035 |
Headgear used with positive airway pressure device |
5,208 |
5,184 |
$55K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,693 |
1,688 |
$53K |
| K0001 |
Standard wheelchair |
2,639 |
2,586 |
$47K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,610 |
3,599 |
$47K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,380 |
1,297 |
$47K |
| A4554 |
Disposable underpads, all sizes |
752 |
725 |
$44K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
2,095 |
2,093 |
$41K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
306 |
304 |
$37K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,732 |
7,673 |
$33K |
| A7037 |
Tubing used with positive airway pressure device |
3,343 |
3,319 |
$32K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,864 |
1,864 |
$23K |
| 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) |
103 |
100 |
$16K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
351 |
351 |
$16K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
424 |
385 |
$14K |
| L3807 |
Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
104 |
97 |
$11K |
| B9002 |
Enteral nutrition infusion pump, any type |
618 |
604 |
$11K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
274 |
273 |
$9K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
163 |
161 |
$8K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,837 |
1,826 |
$7K |
| L3650 |
Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf |
225 |
224 |
$6K |
| E0184 |
Dry pressure mattress |
146 |
146 |
$6K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,520 |
2,493 |
$5K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
37 |
37 |
$5K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
332 |
326 |
$4K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
57 |
57 |
$4K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
53 |
53 |
$4K |
| E0156 |
Seat attachment, walker |
378 |
376 |
$3K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
281 |
279 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
106 |
105 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
82 |
80 |
$2K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
198 |
197 |
$2K |
| E0266 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress |
553 |
540 |
$1K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
12 |
12 |
$614.43 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
194 |
193 |
$544.55 |
| E0240 |
Bath/shower chair, with or without wheels, any size |
14 |
13 |
$349.97 |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
12 |
12 |
$300.50 |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
13 |
12 |
$263.08 |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
14 |
12 |
$221.68 |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
13 |
13 |
$176.62 |
| K0006 |
Heavy duty wheelchair |
12 |
12 |
$141.93 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
12 |
12 |
$84.03 |
| A7036 |
Chinstrap used with positive airway pressure device |
12 |
12 |
$78.52 |
| A7000 |
Canister, disposable, used with suction pump, each |
13 |
12 |
$58.44 |
| A7002 |
Tubing, used with suction pump, each |
28 |
25 |
$20.02 |