| 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 |
38,709 |
30,389 |
$1.45M |
| A7030 |
Full face mask used with positive airway pressure device, each |
7,385 |
6,119 |
$383K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
12,364 |
10,167 |
$277K |
| A7031 |
Face mask interface, replacement for full face mask, each |
8,597 |
7,166 |
$233K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
5,398 |
4,410 |
$184K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
18,687 |
14,609 |
$157K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,037 |
3,472 |
$140K |
| E0570 |
Nebulizer, with compressor |
10,611 |
7,984 |
$118K |
| E1392 |
Portable oxygen concentrator, rental |
11,506 |
8,883 |
$116K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
3,442 |
2,833 |
$105K |
| 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) |
1,520 |
1,245 |
$91K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
4,911 |
3,540 |
$88K |
| A7035 |
Headgear used with positive airway pressure device |
7,020 |
5,775 |
$78K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,510 |
2,638 |
$73K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
2,659 |
2,214 |
$61K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
5,385 |
4,572 |
$57K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
15,135 |
12,568 |
$52K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
6,364 |
5,200 |
$46K |
| E1140 |
Wheelchair, detachable arms, desk or full length, swing away detachable footrests |
1,717 |
1,610 |
$37K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,354 |
938 |
$31K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,664 |
2,135 |
$25K |
| 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 |
244 |
187 |
$24K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,200 |
890 |
$18K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
1,031 |
809 |
$13K |
| K0001 |
Standard wheelchair |
3,955 |
3,005 |
$12K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
83 |
64 |
$10K |
| E1130 |
Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests |
833 |
740 |
$4K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
45 |
36 |
$3K |
| E1150 |
Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests |
68 |
66 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,726 |
677 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,414 |
1,005 |
$2K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
398 |
254 |
$2K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
33 |
25 |
$2K |
| E0156 |
Seat attachment, walker |
272 |
183 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,404 |
1,138 |
$1K |
| A7036 |
Chinstrap used with positive airway pressure device |
137 |
116 |
$835.12 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
19 |
13 |
$580.52 |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
194 |
148 |
$520.43 |
| E1093 |
Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests |
14 |
12 |
$426.94 |
| E0245 |
Tub stool or bench |
14 |
14 |
$420.98 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
17 |
12 |
$22.50 |