| 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 |
5,263 |
3,582 |
$171K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,879 |
3,188 |
$139K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,717 |
1,909 |
$17K |
| E0430 |
Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing |
173 |
99 |
$5K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
362 |
200 |
$3K |
| A7030 |
Full face mask used with positive airway pressure device, each |
110 |
98 |
$2K |
| K0003 |
Lightweight wheelchair |
335 |
254 |
$2K |
| E0570 |
Nebulizer, with compressor |
543 |
378 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
811 |
689 |
$634.86 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
168 |
149 |
$509.06 |
| A7035 |
Headgear used with positive airway pressure device |
181 |
144 |
$484.01 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,381 |
1,165 |
$329.34 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
90 |
75 |
$270.25 |
| A7031 |
Face mask interface, replacement for full face mask, each |
127 |
104 |
$266.94 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
153 |
101 |
$221.88 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
14 |
13 |
$65.86 |
| K0001 |
Standard wheelchair |
20 |
12 |
$34.54 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
72 |
52 |
$2.34 |