| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A7031 |
Face mask interface, replacement for full face mask, each |
2,766 |
2,430 |
$69K |
| E0601 |
Continuous positive airway pressure (cpap) device |
678 |
567 |
$53K |
| A7030 |
Full face mask used with positive airway pressure device, each |
607 |
534 |
$45K |
| K0003 |
Lightweight wheelchair |
1,188 |
1,165 |
$30K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,309 |
1,126 |
$29K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,549 |
4,704 |
$19K |
| A7035 |
Headgear used with positive airway pressure device |
1,321 |
1,134 |
$17K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,220 |
1,027 |
$10K |
| E0570 |
Nebulizer, with compressor |
62 |
62 |
$4K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
173 |
137 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
418 |
346 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
473 |
352 |
$2K |
| L0630 |
Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
12 |
12 |
$1K |
| 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) |
14 |
12 |
$613.10 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
21 |
21 |
$588.73 |
| A4927 |
Gloves, non-sterile, per 100 |
44 |
43 |
$432.74 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
21 |
20 |
$25.76 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
21 |
21 |
$0.00 |
| A7045 |
Exhalation port with or without swivel used with accessories for positive airway devices, replacement only |
12 |
12 |
$0.00 |