| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
3,240 |
2,349 |
$49K |
| A7030 |
Full face mask used with positive airway pressure device, each |
897 |
666 |
$24K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
135 |
125 |
$22K |
| E0667 |
Segmental pneumatic appliance for use with pneumatic compressor, full leg |
215 |
144 |
$19K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,626 |
1,171 |
$18K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,347 |
1,014 |
$16K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
369 |
212 |
$14K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,212 |
888 |
$13K |
| E0651 |
Pneumatic compressor, segmental home model without calibrated gradient pressure |
151 |
102 |
$10K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
312 |
96 |
$9K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,580 |
2,670 |
$6K |
| E0570 |
Nebulizer, with compressor |
688 |
571 |
$6K |
| A7035 |
Headgear used with positive airway pressure device |
771 |
565 |
$4K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
337 |
266 |
$4K |
| K0001 |
Standard wheelchair |
943 |
641 |
$3K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
176 |
118 |
$3K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
238 |
160 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
160 |
125 |
$462.40 |
| E1392 |
Portable oxygen concentrator, rental |
93 |
77 |
$302.47 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
118 |
70 |
$211.32 |
| A7037 |
Tubing used with positive airway pressure device |
37 |
25 |
$180.88 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
14 |
12 |
$121.79 |
| A7015 |
Aerosol mask, used with dme nebulizer |
17 |
13 |
$10.01 |