| 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 |
13,373 |
11,915 |
$602K |
| E0601 |
Continuous positive airway pressure (cpap) device |
6,719 |
6,269 |
$339K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,380 |
2,179 |
$261K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,758 |
1,633 |
$178K |
| 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) |
1,819 |
1,630 |
$173K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,384 |
2,980 |
$164K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,871 |
2,605 |
$147K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,503 |
1,396 |
$144K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
9,387 |
8,218 |
$141K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,117 |
1,921 |
$130K |
| E0570 |
Nebulizer, with compressor |
6,031 |
5,348 |
$122K |
| T4541 |
Incontinence product, disposable underpad, large, each |
3,031 |
2,842 |
$116K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,666 |
3,180 |
$109K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
505 |
489 |
$94K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
226 |
204 |
$67K |
| K0001 |
Standard wheelchair |
3,631 |
3,154 |
$57K |
| A7035 |
Headgear used with positive airway pressure device |
2,789 |
2,560 |
$55K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,405 |
1,272 |
$42K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,028 |
874 |
$42K |
| A7037 |
Tubing used with positive airway pressure device |
1,685 |
1,598 |
$38K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
458 |
415 |
$38K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
844 |
790 |
$28K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
599 |
566 |
$24K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
255 |
242 |
$20K |
| A4927 |
Gloves, non-sterile, per 100 |
1,054 |
854 |
$12K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
185 |
174 |
$10K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,065 |
3,701 |
$10K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
391 |
367 |
$8K |
| A4670 |
Automatic blood pressure monitor |
186 |
175 |
$8K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
901 |
735 |
$8K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,012 |
1,848 |
$4K |
| A7031 |
Face mask interface, replacement for full face mask, each |
291 |
225 |
$4K |
| L1810 |
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
52 |
50 |
$3K |
| E0245 |
Tub stool or bench |
39 |
38 |
$1K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
70 |
38 |
$1K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
12 |
12 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
781 |
705 |
$909.56 |
| E0156 |
Seat attachment, walker |
116 |
95 |
$650.68 |
| K1005 |
Disposable collection and storage bag for breast milk, any size, any type, each |
40 |
37 |
$552.93 |
| E0627 |
Seat lift mechanism, electric, any type |
18 |
12 |
$519.56 |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
30 |
29 |
$163.50 |
| A7000 |
Canister, disposable, used with suction pump, each |
16 |
14 |
$162.95 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
14 |
12 |
$36.84 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
50 |
30 |
$0.00 |