| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
3,913 |
3,590 |
$523K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
3,577 |
2,875 |
$460K |
| A7030 |
Full face mask used with positive airway pressure device, each |
4,231 |
3,990 |
$314K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,478 |
4,014 |
$270K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
1,644 |
1,363 |
$171K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,084 |
1,054 |
$169K |
| T4541 |
Incontinence product, disposable underpad, large, each |
3,254 |
3,117 |
$164K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,458 |
3,144 |
$141K |
| E0570 |
Nebulizer, with compressor |
4,770 |
4,432 |
$137K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,026 |
1,919 |
$113K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,608 |
1,513 |
$90K |
| A7037 |
Tubing used with positive airway pressure device |
5,530 |
5,220 |
$87K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,694 |
2,522 |
$76K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
794 |
761 |
$74K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
436 |
421 |
$71K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
445 |
420 |
$71K |
| A7035 |
Headgear used with positive airway pressure device |
3,679 |
3,498 |
$65K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
8,233 |
7,803 |
$47K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,458 |
2,338 |
$45K |
| A4554 |
Disposable underpads, all sizes |
2,976 |
1,434 |
$44K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,228 |
2,847 |
$41K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
850 |
714 |
$37K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,305 |
1,240 |
$35K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,323 |
1,258 |
$33K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
889 |
799 |
$29K |
| A4553 |
Non-disposable underpads, all sizes |
1,719 |
1,645 |
$25K |
| K0001 |
Standard wheelchair |
1,494 |
1,371 |
$25K |
| A4927 |
Gloves, non-sterile, per 100 |
1,827 |
1,681 |
$22K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
532 |
516 |
$21K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
513 |
501 |
$21K |
| L0641 |
Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
320 |
302 |
$19K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
340 |
231 |
$15K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
185 |
160 |
$14K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,576 |
1,489 |
$12K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
735 |
682 |
$9K |
| 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) |
89 |
78 |
$9K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,833 |
2,658 |
$7K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
39 |
39 |
$6K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
52 |
44 |
$5K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
196 |
192 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,521 |
1,423 |
$2K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
31 |
27 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
14 |
13 |
$513.35 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
12 |
12 |
$320.05 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
65 |
63 |
$2.35 |
| A4453 |
Rectal catheter with or without balloon, for use with any type transanal irrigation system, each |
14 |
14 |
$0.00 |