| 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 |
9,187 |
8,669 |
$1.17M |
| E0601 |
Continuous positive airway pressure (cpap) device |
16,529 |
15,844 |
$916K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,840 |
3,832 |
$272K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
11,302 |
10,568 |
$241K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
5,382 |
5,371 |
$224K |
| 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) |
1,647 |
1,589 |
$186K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,529 |
6,131 |
$150K |
| A7031 |
Face mask interface, replacement for full face mask, each |
5,233 |
5,202 |
$140K |
| A7035 |
Headgear used with positive airway pressure device |
7,617 |
7,602 |
$125K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,412 |
4,403 |
$104K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
3,717 |
3,688 |
$83K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
917 |
881 |
$81K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
717 |
654 |
$73K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
3,743 |
3,713 |
$65K |
| A7037 |
Tubing used with positive airway pressure device |
4,696 |
4,684 |
$64K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
17,264 |
17,125 |
$58K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
558 |
521 |
$55K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
382 |
348 |
$46K |
| 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) |
177 |
164 |
$43K |
| A7000 |
Canister, disposable, used with suction pump, each |
2,504 |
2,390 |
$39K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
672 |
634 |
$28K |
| A4217 |
Sterile water/saline, 500 ml |
1,444 |
1,268 |
$27K |
| A7002 |
Tubing, used with suction pump, each |
2,624 |
2,444 |
$24K |
| K0001 |
Standard wheelchair |
747 |
685 |
$22K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
865 |
827 |
$22K |
| E0570 |
Nebulizer, with compressor |
885 |
873 |
$20K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
2,069 |
1,957 |
$18K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
224 |
206 |
$9K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,067 |
2,065 |
$8K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,140 |
2,044 |
$8K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
792 |
746 |
$7K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
604 |
585 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
405 |
362 |
$5K |
| A4481 |
Tracheostoma filter, any type, any size, each |
263 |
251 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
53 |
53 |
$4K |
| A7036 |
Chinstrap used with positive airway pressure device |
217 |
217 |
$2K |
| A7525 |
Tracheostomy mask, each |
485 |
427 |
$2K |
| A7526 |
Tracheostomy tube collar/holder, each |
82 |
77 |
$2K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
24 |
24 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
13 |
12 |
$26.95 |