| 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 |
16,384 |
13,914 |
$672K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,306 |
9,639 |
$110K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,401 |
2,123 |
$85K |
| 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) |
1,259 |
1,059 |
$84K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
694 |
604 |
$22K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
625 |
557 |
$18K |
| A7030 |
Full face mask used with positive airway pressure device, each |
423 |
349 |
$14K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
692 |
612 |
$14K |
| A7035 |
Headgear used with positive airway pressure device |
1,195 |
1,046 |
$13K |
| E0570 |
Nebulizer, with compressor |
890 |
735 |
$12K |
| A7037 |
Tubing used with positive airway pressure device |
1,154 |
1,041 |
$10K |
| A7031 |
Face mask interface, replacement for full face mask, each |
541 |
473 |
$10K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
477 |
430 |
$9K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,090 |
976 |
$8K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,856 |
2,453 |
$8K |
| E1392 |
Portable oxygen concentrator, rental |
414 |
337 |
$5K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
906 |
790 |
$4K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
168 |
142 |
$3K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
20 |
12 |
$3K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
376 |
317 |
$2K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
172 |
146 |
$564.70 |
| K0003 |
Lightweight wheelchair |
12 |
12 |
$323.51 |