| 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 |
376 |
371 |
$26K |
| E0601 |
Continuous positive airway pressure (cpap) device |
518 |
470 |
$23K |
| A7030 |
Full face mask used with positive airway pressure device, each |
140 |
127 |
$9K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
132 |
117 |
$6K |
| A7037 |
Tubing used with positive airway pressure device |
288 |
262 |
$4K |
| A7031 |
Face mask interface, replacement for full face mask, each |
126 |
110 |
$3K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
77 |
68 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
209 |
185 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
598 |
548 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
193 |
171 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
140 |
124 |
$1K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
52 |
52 |
$809.03 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
12 |
12 |
$262.83 |
| K0001 |
Standard wheelchair |
12 |
12 |
$83.03 |