| 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 |
23,395 |
23,328 |
$1.56M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,248 |
1,246 |
$396K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
14,184 |
14,127 |
$170K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,678 |
2,660 |
$168K |
| K0001 |
Standard wheelchair |
3,493 |
3,480 |
$93K |
| E0570 |
Nebulizer, with compressor |
8,154 |
8,088 |
$70K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,558 |
1,551 |
$58K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,124 |
2,109 |
$55K |
| 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 |
2,191 |
2,191 |
$46K |
| A7030 |
Full face mask used with positive airway pressure device, each |
686 |
683 |
$46K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,636 |
1,636 |
$46K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,018 |
1,018 |
$45K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
1,421 |
1,417 |
$38K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,138 |
1,134 |
$35K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,556 |
1,556 |
$34K |
| A7035 |
Headgear used with positive airway pressure device |
2,014 |
2,009 |
$33K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,547 |
5,532 |
$33K |
| 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) |
192 |
192 |
$29K |
| A7031 |
Face mask interface, replacement for full face mask, each |
696 |
691 |
$22K |
| E1392 |
Portable oxygen concentrator, rental |
1,174 |
1,174 |
$18K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,726 |
1,723 |
$17K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
131 |
131 |
$11K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
696 |
696 |
$7K |
| A7037 |
Tubing used with positive airway pressure device |
363 |
363 |
$5K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
154 |
154 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,208 |
1,162 |
$4K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
133 |
130 |
$3K |
| E0271 |
Mattress, innerspring |
107 |
107 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
180 |
180 |
$1K |
| E0305 |
Bed side rails, half length |
94 |
94 |
$1K |
| K0003 |
Lightweight wheelchair |
28 |
28 |
$615.48 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
13 |
12 |
$575.19 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
365 |
349 |
$421.15 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
24 |
24 |
$195.11 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
12 |
12 |
$74.92 |