| 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 |
10,179 |
9,255 |
$399K |
| E0601 |
Continuous positive airway pressure (cpap) device |
5,735 |
5,317 |
$138K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,044 |
6,396 |
$116K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,555 |
1,447 |
$79K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,575 |
2,358 |
$61K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
981 |
923 |
$34K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,394 |
1,264 |
$30K |
| A7035 |
Headgear used with positive airway pressure device |
1,756 |
1,641 |
$20K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,317 |
2,841 |
$19K |
| A7037 |
Tubing used with positive airway pressure device |
1,984 |
1,858 |
$17K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
684 |
603 |
$14K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
511 |
474 |
$9K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
623 |
586 |
$9K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
419 |
392 |
$9K |
| K0001 |
Standard wheelchair |
566 |
528 |
$8K |
| E0570 |
Nebulizer, with compressor |
1,790 |
1,648 |
$8K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
741 |
690 |
$6K |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
443 |
364 |
$5K |
| E1392 |
Portable oxygen concentrator, rental |
205 |
203 |
$5K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
15 |
13 |
$4K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
68 |
67 |
$839.98 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
40 |
37 |
$689.72 |
| 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) |
12 |
12 |
$523.56 |