| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
491 |
469 |
$57K |
| A7030 |
Full face mask used with positive airway pressure device, each |
570 |
544 |
$56K |
| A7031 |
Face mask interface, replacement for full face mask, each |
557 |
535 |
$49K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
344 |
330 |
$39K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,046 |
1,006 |
$36K |
| 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) |
220 |
206 |
$34K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
171 |
171 |
$33K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
551 |
493 |
$31K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
487 |
470 |
$30K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
657 |
619 |
$18K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,197 |
1,143 |
$16K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
133 |
129 |
$14K |
| A7035 |
Headgear used with positive airway pressure device |
592 |
567 |
$13K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
137 |
131 |
$11K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
219 |
207 |
$10K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
98 |
91 |
$6K |
| K0001 |
Standard wheelchair |
207 |
198 |
$5K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
51 |
49 |
$5K |
| E0570 |
Nebulizer, with compressor |
180 |
173 |
$5K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
471 |
456 |
$5K |
| T4541 |
Incontinence product, disposable underpad, large, each |
157 |
156 |
$3K |
| A4927 |
Gloves, non-sterile, per 100 |
241 |
210 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
73 |
68 |
$3K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
226 |
200 |
$2K |
| E1392 |
Portable oxygen concentrator, rental |
112 |
103 |
$2K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
13 |
13 |
$1K |
| A7036 |
Chinstrap used with positive airway pressure device |
61 |
58 |
$617.14 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
13 |
13 |
$610.63 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
69 |
61 |
$590.07 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
13 |
12 |
$206.97 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
12 |
12 |
$164.68 |