| 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 |
19,045 |
17,857 |
$1.64M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
14,785 |
13,734 |
$227K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,817 |
4,261 |
$213K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,257 |
2,159 |
$180K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,970 |
2,784 |
$96K |
| E0570 |
Nebulizer, with compressor |
1,721 |
1,630 |
$95K |
| 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) |
510 |
432 |
$40K |
| A7037 |
Tubing used with positive airway pressure device |
2,803 |
2,634 |
$33K |
| A7035 |
Headgear used with positive airway pressure device |
1,850 |
1,750 |
$30K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
530 |
505 |
$27K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
441 |
429 |
$26K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
6,515 |
5,902 |
$25K |
| K0001 |
Standard wheelchair |
1,226 |
1,153 |
$22K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
781 |
680 |
$21K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
937 |
887 |
$10K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
185 |
169 |
$9K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
195 |
183 |
$7K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
137 |
130 |
$6K |
| E1392 |
Portable oxygen concentrator, rental |
299 |
280 |
$5K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
927 |
853 |
$4K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
66 |
66 |
$3K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
44 |
44 |
$2K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
48 |
48 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
85 |
76 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
150 |
146 |
$2K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
75 |
66 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
124 |
122 |
$2K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
31 |
26 |
$1K |
| A4670 |
Automatic blood pressure monitor |
19 |
19 |
$479.93 |
| E0156 |
Seat attachment, walker |
15 |
13 |
$146.21 |
| A7015 |
Aerosol mask, used with dme nebulizer |
64 |
56 |
$78.96 |