| 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 |
6,476 |
4,278 |
$297K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,131 |
2,656 |
$97K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,504 |
1,021 |
$54K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,960 |
2,659 |
$30K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,175 |
858 |
$26K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,735 |
1,058 |
$22K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
102 |
80 |
$18K |
| 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) |
159 |
132 |
$16K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
516 |
393 |
$15K |
| A7035 |
Headgear used with positive airway pressure device |
1,500 |
1,017 |
$12K |
| K0001 |
Standard wheelchair |
978 |
799 |
$10K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,053 |
796 |
$9K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
303 |
228 |
$8K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
58 |
51 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,461 |
2,241 |
$6K |
| A7037 |
Tubing used with positive airway pressure device |
623 |
402 |
$5K |
| E1392 |
Portable oxygen concentrator, rental |
257 |
206 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
497 |
389 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
258 |
224 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
80 |
73 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
67 |
52 |
$725.78 |
| E0570 |
Nebulizer, with compressor |
17 |
13 |
$606.01 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
15 |
12 |
$374.73 |
| A7526 |
Tracheostomy tube collar/holder, each |
15 |
12 |
$331.98 |