| 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 |
6,558 |
6,217 |
$263K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,301 |
3,218 |
$27K |
| E0601 |
Continuous positive airway pressure (cpap) device |
675 |
643 |
$10K |
| E1392 |
Portable oxygen concentrator, rental |
516 |
482 |
$9K |
| E0570 |
Nebulizer, with compressor |
736 |
702 |
$6K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
137 |
131 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
678 |
654 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
220 |
217 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
204 |
195 |
$3K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
119 |
113 |
$3K |
| K0001 |
Standard wheelchair |
850 |
845 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
189 |
186 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
158 |
148 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
211 |
206 |
$1K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
42 |
39 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
27 |
27 |
$990.19 |
| A7031 |
Face mask interface, replacement for full face mask, each |
14 |
12 |
$566.12 |
| 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) |
12 |
12 |
$369.48 |
| A7030 |
Full face mask used with positive airway pressure device, each |
15 |
14 |
$229.44 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
12 |
12 |
$53.14 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
13 |
12 |
$23.18 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
13 |
13 |
$0.00 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
204 |
203 |
$0.00 |