| 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 |
6,932 |
6,819 |
$329K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,918 |
4,832 |
$51K |
| A7031 |
Face mask interface, replacement for full face mask, each |
653 |
628 |
$21K |
| A7030 |
Full face mask used with positive airway pressure device, each |
103 |
101 |
$5K |
| E0601 |
Continuous positive airway pressure (cpap) device |
275 |
270 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,363 |
1,310 |
$5K |
| A7037 |
Tubing used with positive airway pressure device |
310 |
305 |
$5K |
| K0001 |
Standard wheelchair |
240 |
230 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
276 |
270 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
152 |
152 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
65 |
62 |
$2K |
| E0570 |
Nebulizer, with compressor |
716 |
710 |
$963.66 |
| A7035 |
Headgear used with positive airway pressure device |
83 |
83 |
$792.97 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
12 |
12 |
$53.31 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
53 |
50 |
$40.72 |