| 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 |
9,763 |
6,835 |
$601K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,300 |
1,145 |
$201K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,653 |
831 |
$191K |
| 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 |
3,698 |
3,068 |
$79K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,557 |
1,304 |
$64K |
| 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 |
699 |
375 |
$64K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
798 |
407 |
$41K |
| K0003 |
Lightweight wheelchair |
1,085 |
939 |
$38K |
| B9002 |
Enteral nutrition infusion pump, any type |
469 |
400 |
$38K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,336 |
998 |
$35K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
734 |
666 |
$35K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 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 |
518 |
281 |
$35K |
| E1392 |
Portable oxygen concentrator, rental |
1,354 |
1,127 |
$28K |
| A4554 |
Disposable underpads, all sizes |
579 |
522 |
$28K |
| A7030 |
Full face mask used with positive airway pressure device, each |
366 |
335 |
$27K |
| K0001 |
Standard wheelchair |
1,431 |
1,227 |
$19K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
423 |
373 |
$18K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,011 |
947 |
$16K |
| E0570 |
Nebulizer, with compressor |
997 |
973 |
$16K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,727 |
1,654 |
$13K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
441 |
335 |
$13K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
381 |
312 |
$10K |
| A7035 |
Headgear used with positive airway pressure device |
581 |
544 |
$10K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
210 |
199 |
$9K |
| B9998 |
Noc for enteral supplies |
1,031 |
427 |
$8K |
| A7037 |
Tubing used with positive airway pressure device |
303 |
288 |
$7K |
| A7031 |
Face mask interface, replacement for full face mask, each |
265 |
227 |
$7K |
| A7000 |
Canister, disposable, used with suction pump, each |
394 |
285 |
$6K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
90 |
83 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
26 |
24 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
882 |
731 |
$2K |
| K0006 |
Heavy duty wheelchair |
31 |
24 |
$1K |
| 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) |
15 |
12 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
191 |
169 |
$1K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
12 |
12 |
$740.19 |
| A7526 |
Tracheostomy tube collar/holder, each |
71 |
39 |
$722.25 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
24 |
24 |
$653.39 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
347 |
317 |
$441.12 |
| E0156 |
Seat attachment, walker |
52 |
45 |
$405.25 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
12 |
12 |
$393.66 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
42 |
28 |
$367.80 |
| K0004 |
High strength, lightweight wheelchair |
99 |
68 |
$344.86 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
16 |
13 |
$272.87 |
| A7002 |
Tubing, used with suction pump, each |
69 |
57 |
$195.11 |
| A7015 |
Aerosol mask, used with dme nebulizer |
26 |
25 |
$39.09 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
68 |
65 |
$32.84 |