| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
16,345 |
11,714 |
$392K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,289 |
758 |
$196K |
| E0601 |
Continuous positive airway pressure (cpap) device |
7,230 |
5,590 |
$154K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,200 |
1,531 |
$51K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
5,156 |
4,126 |
$46K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,132 |
5,050 |
$32K |
| 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) |
488 |
366 |
$21K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,867 |
1,313 |
$21K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
886 |
683 |
$19K |
| E0570 |
Nebulizer, with compressor |
4,133 |
3,182 |
$14K |
| A7037 |
Tubing used with positive airway pressure device |
2,847 |
2,083 |
$12K |
| A7035 |
Headgear used with positive airway pressure device |
2,092 |
1,526 |
$12K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,200 |
3,013 |
$9K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
264 |
201 |
$9K |
| E1392 |
Portable oxygen concentrator, rental |
1,067 |
733 |
$6K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
289 |
233 |
$5K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,084 |
787 |
$5K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
889 |
648 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
74 |
51 |
$828.30 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
48 |
43 |
$731.56 |
| K0001 |
Standard wheelchair |
66 |
54 |
$65.88 |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
923 |
595 |
$2.00 |