| 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 |
9,305 |
9,283 |
$832K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,429 |
4,398 |
$222K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,428 |
5,415 |
$114K |
| 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) |
579 |
579 |
$59K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,900 |
1,899 |
$50K |
| K0003 |
Lightweight wheelchair |
1,143 |
1,132 |
$40K |
| A7030 |
Full face mask used with positive airway pressure device, each |
499 |
496 |
$32K |
| E0570 |
Nebulizer, with compressor |
860 |
860 |
$18K |
| A7035 |
Headgear used with positive airway pressure device |
933 |
916 |
$17K |
| K0001 |
Standard wheelchair |
1,800 |
1,767 |
$15K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
158 |
158 |
$12K |
| A7037 |
Tubing used with positive airway pressure device |
453 |
451 |
$11K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,427 |
1,409 |
$10K |
| K0004 |
High strength, lightweight wheelchair |
123 |
123 |
$10K |
| A7031 |
Face mask interface, replacement for full face mask, each |
149 |
143 |
$4K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
102 |
101 |
$4K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
670 |
667 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
105 |
105 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
12 |
12 |
$692.06 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
37 |
37 |
$459.87 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
49 |
49 |
$242.68 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
12 |
12 |
$77.88 |