| 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 |
9,374 |
7,892 |
$487K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,970 |
5,895 |
$83K |
| A7030 |
Full face mask used with positive airway pressure device, each |
790 |
705 |
$61K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,386 |
1,162 |
$59K |
| A7031 |
Face mask interface, replacement for full face mask, each |
536 |
497 |
$27K |
| 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) |
204 |
173 |
$21K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
809 |
506 |
$20K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
163 |
115 |
$16K |
| A7037 |
Tubing used with positive airway pressure device |
740 |
673 |
$11K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,501 |
1,348 |
$11K |
| A7035 |
Headgear used with positive airway pressure device |
708 |
630 |
$11K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
344 |
244 |
$10K |
| K0001 |
Standard wheelchair |
416 |
309 |
$8K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
154 |
147 |
$7K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
60 |
52 |
$6K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
23 |
14 |
$4K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
86 |
81 |
$3K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
218 |
153 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
254 |
239 |
$2K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
18 |
12 |
$2K |
| E0570 |
Nebulizer, with compressor |
183 |
142 |
$1K |
| K0003 |
Lightweight wheelchair |
115 |
81 |
$1K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
44 |
26 |
$1K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
13 |
12 |
$991.69 |
| A4452 |
Tape, waterproof, per 18 square inches |
35 |
25 |
$541.07 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
136 |
99 |
$409.23 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
45 |
42 |
$241.92 |