| 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 |
13,724 |
9,537 |
$336K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,962 |
2,807 |
$75K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,360 |
1,096 |
$57K |
| E0570 |
Nebulizer, with compressor |
4,262 |
3,334 |
$46K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,736 |
4,852 |
$40K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,079 |
933 |
$40K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,889 |
2,148 |
$27K |
| E1392 |
Portable oxygen concentrator, rental |
2,179 |
1,648 |
$26K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,166 |
1,468 |
$25K |
| A7035 |
Headgear used with positive airway pressure device |
2,044 |
1,709 |
$22K |
| A7031 |
Face mask interface, replacement for full face mask, each |
921 |
709 |
$15K |
| A7037 |
Tubing used with positive airway pressure device |
1,744 |
1,460 |
$13K |
| K0001 |
Standard wheelchair |
1,758 |
1,293 |
$11K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
291 |
280 |
$11K |
| 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 |
1,105 |
767 |
$10K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
919 |
838 |
$8K |
| 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) |
146 |
104 |
$7K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
944 |
798 |
$7K |
| K0003 |
Lightweight wheelchair |
421 |
253 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,207 |
2,342 |
$5K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
226 |
179 |
$4K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
123 |
101 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
217 |
174 |
$659.99 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
35 |
13 |
$602.04 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
16 |
12 |
$267.54 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
131 |
65 |
$140.26 |
| A7015 |
Aerosol mask, used with dme nebulizer |
30 |
27 |
$29.05 |