| 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 |
15,704 |
15,682 |
$1.36M |
| E0601 |
Continuous positive airway pressure (cpap) device |
8,209 |
8,188 |
$781K |
| 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) |
2,063 |
2,063 |
$485K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
984 |
981 |
$408K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
5,369 |
5,363 |
$320K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,942 |
3,939 |
$183K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,988 |
2,985 |
$150K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,732 |
3,716 |
$118K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
277 |
266 |
$114K |
| 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 |
4,234 |
4,226 |
$101K |
| A7035 |
Headgear used with positive airway pressure device |
5,955 |
5,951 |
$101K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
2,589 |
2,574 |
$92K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,052 |
3,049 |
$87K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
231 |
231 |
$83K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
13,740 |
13,721 |
$82K |
| E0570 |
Nebulizer, with compressor |
4,321 |
4,308 |
$80K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,808 |
2,803 |
$78K |
| E1392 |
Portable oxygen concentrator, rental |
3,155 |
3,155 |
$72K |
| A7037 |
Tubing used with positive airway pressure device |
4,647 |
4,645 |
$66K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
4,618 |
4,611 |
$48K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
4,615 |
4,612 |
$31K |
| K0001 |
Standard wheelchair |
428 |
427 |
$13K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
320 |
319 |
$6K |
| A7036 |
Chinstrap used with positive airway pressure device |
420 |
420 |
$4K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
18 |
12 |
$2K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
12 |
12 |
$2K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
15 |
14 |
$1K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
19 |
12 |
$778.12 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
80 |
80 |
$730.64 |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
12 |
12 |
$658.02 |