| 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 |
17,366 |
16,617 |
$976K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,240 |
2,200 |
$616K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,691 |
4,527 |
$171K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,406 |
2,321 |
$141K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
9,511 |
9,058 |
$112K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,670 |
3,514 |
$61K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,138 |
2,065 |
$56K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,315 |
1,252 |
$50K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,027 |
987 |
$43K |
| A7035 |
Headgear used with positive airway pressure device |
2,634 |
2,495 |
$40K |
| A7037 |
Tubing used with positive airway pressure device |
3,386 |
3,244 |
$40K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,294 |
6,864 |
$37K |
| K0001 |
Standard wheelchair |
2,002 |
1,945 |
$36K |
| E0570 |
Nebulizer, with compressor |
5,826 |
5,699 |
$30K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
919 |
897 |
$27K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,475 |
2,337 |
$22K |
| E1392 |
Portable oxygen concentrator, rental |
2,314 |
2,240 |
$19K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
722 |
693 |
$12K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
304 |
286 |
$9K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
188 |
182 |
$5K |
| 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) |
51 |
48 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,143 |
2,924 |
$3K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
12 |
12 |
$299.20 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
52 |
52 |
$245.09 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
158 |
152 |
$65.10 |
| A7015 |
Aerosol mask, used with dme nebulizer |
33 |
33 |
$15.98 |