| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
3,400 |
3,397 |
$513K |
| E0601 |
Continuous positive airway pressure (cpap) device |
14,255 |
14,214 |
$490K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,300 |
3,286 |
$166K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
1,170 |
1,151 |
$146K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,182 |
3,161 |
$135K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,046 |
2,012 |
$107K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,708 |
1,703 |
$97K |
| 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) |
938 |
936 |
$94K |
| A4554 |
Disposable underpads, all sizes |
1,905 |
1,890 |
$86K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,020 |
1,964 |
$77K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,782 |
2,768 |
$74K |
| K0001 |
Standard wheelchair |
4,405 |
4,357 |
$53K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
760 |
738 |
$51K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,015 |
1,006 |
$33K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,013 |
1,984 |
$31K |
| A7035 |
Headgear used with positive airway pressure device |
3,032 |
3,015 |
$30K |
| E0266 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress |
296 |
295 |
$30K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
273 |
270 |
$28K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
726 |
718 |
$28K |
| E0570 |
Nebulizer, with compressor |
671 |
671 |
$25K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
876 |
858 |
$25K |
| A7031 |
Face mask interface, replacement for full face mask, each |
946 |
938 |
$24K |
| A7037 |
Tubing used with positive airway pressure device |
2,006 |
1,996 |
$21K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,167 |
1,134 |
$18K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,523 |
1,509 |
$17K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,020 |
1,006 |
$15K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,674 |
4,652 |
$14K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,932 |
2,899 |
$13K |
| E0561 |
Humidifier, non-heated, used with positive airway pressure device |
235 |
235 |
$12K |
| E1399 |
Durable medical equipment, miscellaneous |
179 |
163 |
$11K |
| E1392 |
Portable oxygen concentrator, rental |
507 |
506 |
$10K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
268 |
268 |
$9K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
51 |
50 |
$7K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,480 |
1,474 |
$6K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
453 |
450 |
$5K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
207 |
207 |
$4K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
107 |
107 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
1,104 |
1,101 |
$3K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
217 |
202 |
$3K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
998 |
666 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
128 |
128 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
469 |
466 |
$2K |
| E0156 |
Seat attachment, walker |
135 |
133 |
$2K |
| 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 |
219 |
219 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
527 |
526 |
$1K |
| 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 |
80 |
70 |
$1K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
52 |
51 |
$988.64 |
| K0003 |
Lightweight wheelchair |
130 |
129 |
$974.02 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
25 |
25 |
$295.48 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
25 |
25 |
$140.80 |
| A7015 |
Aerosol mask, used with dme nebulizer |
86 |
86 |
$81.66 |