| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
4,524 |
4,400 |
$1.84M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
23,616 |
23,125 |
$1.51M |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
2,581 |
2,516 |
$850K |
| E0601 |
Continuous positive airway pressure (cpap) device |
6,348 |
6,143 |
$307K |
| T4541 |
Incontinence product, disposable underpad, large, each |
6,071 |
6,037 |
$279K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,796 |
3,755 |
$225K |
| 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) |
1,212 |
1,174 |
$159K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,581 |
3,463 |
$153K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,194 |
2,184 |
$143K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
9,672 |
9,532 |
$134K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,280 |
2,257 |
$121K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,276 |
8,117 |
$106K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,439 |
3,384 |
$84K |
| K0001 |
Standard wheelchair |
3,255 |
3,180 |
$74K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,402 |
1,394 |
$71K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,447 |
1,439 |
$65K |
| E0570 |
Nebulizer, with compressor |
5,724 |
5,490 |
$48K |
| 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 |
1,462 |
1,438 |
$40K |
| E1392 |
Portable oxygen concentrator, rental |
1,685 |
1,667 |
$35K |
| S9999 |
Sales tax |
10,566 |
10,264 |
$27K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,138 |
1,132 |
$26K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,004 |
998 |
$26K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
796 |
792 |
$25K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,475 |
5,451 |
$21K |
| A7035 |
Headgear used with positive airway pressure device |
1,891 |
1,882 |
$20K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,948 |
1,916 |
$19K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
477 |
473 |
$14K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
2,465 |
2,456 |
$8K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,017 |
1,012 |
$7K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
123 |
123 |
$4K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
16 |
15 |
$2K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
170 |
168 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
152 |
152 |
$796.83 |
| A7036 |
Chinstrap used with positive airway pressure device |
24 |
24 |
$174.82 |