| 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 |
8,011 |
7,530 |
$307K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,171 |
1,146 |
$51K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,771 |
1,728 |
$50K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,829 |
1,796 |
$48K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,135 |
3,871 |
$30K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,185 |
1,170 |
$16K |
| A7037 |
Tubing used with positive airway pressure device |
2,036 |
1,986 |
$15K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
433 |
419 |
$11K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,143 |
3,048 |
$11K |
| A7035 |
Headgear used with positive airway pressure device |
1,219 |
1,194 |
$11K |
| E0570 |
Nebulizer, with compressor |
2,014 |
1,911 |
$11K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
180 |
172 |
$8K |
| E1392 |
Portable oxygen concentrator, rental |
610 |
557 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
599 |
583 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
38 |
37 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
184 |
177 |
$573.20 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
39 |
37 |
$234.67 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
31 |
26 |
$232.18 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
178 |
157 |
$130.82 |
| K0001 |
Standard wheelchair |
12 |
12 |
$74.19 |