| 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 |
19,102 |
18,071 |
$1.07M |
| E0601 |
Continuous positive airway pressure (cpap) device |
13,115 |
12,719 |
$776K |
| 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) |
3,009 |
2,893 |
$418K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,080 |
2,002 |
$223K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,134 |
2,891 |
$176K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,373 |
5,153 |
$151K |
| 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 |
5,136 |
4,848 |
$132K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,576 |
4,239 |
$109K |
| E1392 |
Portable oxygen concentrator, rental |
5,410 |
5,042 |
$107K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,620 |
2,435 |
$86K |
| A7035 |
Headgear used with positive airway pressure device |
4,110 |
3,834 |
$80K |
| E0570 |
Nebulizer, with compressor |
2,675 |
2,519 |
$75K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,585 |
1,521 |
$71K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,227 |
2,008 |
$53K |
| K0001 |
Standard wheelchair |
1,790 |
1,658 |
$48K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
78 |
77 |
$47K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,187 |
6,520 |
$17K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
893 |
807 |
$17K |
| A7037 |
Tubing used with positive airway pressure device |
771 |
715 |
$13K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
220 |
194 |
$12K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
725 |
672 |
$11K |
| 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) |
71 |
66 |
$10K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
494 |
469 |
$7K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
491 |
405 |
$6K |
| T4541 |
Incontinence product, disposable underpad, large, each |
101 |
80 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
67 |
63 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,540 |
1,377 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
162 |
150 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
961 |
914 |
$1K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
335 |
281 |
$810.68 |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
13 |
12 |
$504.85 |
| A4927 |
Gloves, non-sterile, per 100 |
15 |
12 |
$216.38 |
| E1356 |
Oxygen accessory, battery pack/cartridge for portable concentrator, any type, replacement only, each |
1,116 |
1,114 |
$0.00 |