| 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 |
24,161 |
22,100 |
$983K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,575 |
1,360 |
$489K |
| E0601 |
Continuous positive airway pressure (cpap) device |
5,954 |
5,508 |
$221K |
| 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) |
1,668 |
1,532 |
$160K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,151 |
9,961 |
$149K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,535 |
2,236 |
$100K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,846 |
1,677 |
$59K |
| E0570 |
Nebulizer, with compressor |
1,778 |
1,654 |
$28K |
| A7035 |
Headgear used with positive airway pressure device |
1,910 |
1,750 |
$20K |
| A7037 |
Tubing used with positive airway pressure device |
2,545 |
2,332 |
$20K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,145 |
1,025 |
$12K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
516 |
458 |
$8K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,807 |
3,352 |
$8K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,575 |
1,467 |
$8K |
| E1392 |
Portable oxygen concentrator, rental |
602 |
532 |
$7K |
| K0003 |
Lightweight wheelchair |
110 |
100 |
$5K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
185 |
169 |
$4K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
118 |
102 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
153 |
132 |
$2K |
| K0001 |
Standard wheelchair |
117 |
105 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
401 |
368 |
$540.99 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
45 |
42 |
$382.05 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
15 |
13 |
$208.00 |
| 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 |
42 |
40 |
$118.60 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
12 |
12 |
$77.76 |