| 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 |
4,056 |
3,799 |
$180K |
| A7030 |
Full face mask used with positive airway pressure device, each |
417 |
405 |
$38K |
| E0601 |
Continuous positive airway pressure (cpap) device |
805 |
738 |
$32K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
587 |
579 |
$23K |
| A7031 |
Face mask interface, replacement for full face mask, each |
534 |
512 |
$19K |
| E1392 |
Portable oxygen concentrator, rental |
1,733 |
1,597 |
$17K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
225 |
224 |
$16K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,768 |
1,672 |
$15K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
743 |
694 |
$14K |
| 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) |
110 |
108 |
$13K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
185 |
185 |
$10K |
| A7035 |
Headgear used with positive airway pressure device |
473 |
464 |
$9K |
| E0570 |
Nebulizer, with compressor |
430 |
366 |
$8K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
41 |
41 |
$7K |
| K0001 |
Standard wheelchair |
272 |
262 |
$5K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
94 |
94 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
901 |
877 |
$5K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
168 |
166 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
54 |
49 |
$608.08 |
| A7000 |
Canister, disposable, used with suction pump, each |
26 |
26 |
$354.20 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
12 |
12 |
$264.37 |
| A7037 |
Tubing used with positive airway pressure device |
13 |
12 |
$217.60 |
| A7002 |
Tubing, used with suction pump, each |
29 |
26 |
$161.15 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
13 |
13 |
$113.62 |