| 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 |
20,991 |
16,764 |
$456K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
5,346 |
4,136 |
$69K |
| E0570 |
Nebulizer, with compressor |
11,640 |
9,154 |
$68K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,912 |
3,164 |
$64K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,863 |
9,466 |
$54K |
| K0001 |
Standard wheelchair |
6,872 |
5,356 |
$45K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,195 |
957 |
$38K |
| E1392 |
Portable oxygen concentrator, rental |
3,186 |
2,546 |
$30K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,770 |
1,439 |
$28K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,293 |
3,439 |
$24K |
| A7035 |
Headgear used with positive airway pressure device |
1,414 |
1,133 |
$10K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
626 |
484 |
$7K |
| K0003 |
Lightweight wheelchair |
1,015 |
746 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,440 |
1,989 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,849 |
2,446 |
$4K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
119 |
103 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
551 |
458 |
$2K |
| 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) |
56 |
43 |
$2K |
| K0007 |
Extra heavy duty wheelchair |
73 |
63 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
132 |
89 |
$1K |
| A7031 |
Face mask interface, replacement for full face mask, each |
66 |
55 |
$1K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
333 |
232 |
$924.94 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
60 |
51 |
$772.35 |
| A7015 |
Aerosol mask, used with dme nebulizer |
793 |
742 |
$719.20 |
| E0156 |
Seat attachment, walker |
186 |
151 |
$574.30 |
| A7037 |
Tubing used with positive airway pressure device |
64 |
54 |
$370.48 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
12 |
12 |
$297.86 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
25 |
24 |
$63.14 |