| 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 |
24,991 |
23,154 |
$977K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,349 |
682 |
$708K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,885 |
11,005 |
$295K |
| E0601 |
Continuous positive airway pressure (cpap) device |
5,691 |
4,999 |
$90K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,712 |
2,324 |
$70K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,729 |
3,152 |
$44K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,139 |
1,884 |
$35K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,179 |
1,930 |
$33K |
| A7037 |
Tubing used with positive airway pressure device |
5,333 |
4,728 |
$30K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
10,242 |
9,055 |
$29K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,700 |
3,270 |
$27K |
| A7035 |
Headgear used with positive airway pressure device |
3,416 |
3,026 |
$27K |
| E1392 |
Portable oxygen concentrator, rental |
1,990 |
1,867 |
$24K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
108 |
87 |
$21K |
| E0570 |
Nebulizer, with compressor |
2,152 |
2,006 |
$16K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,017 |
2,675 |
$15K |
| K0001 |
Standard wheelchair |
625 |
576 |
$6K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
253 |
236 |
$5K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,448 |
1,283 |
$5K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
313 |
290 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
62 |
61 |
$2K |
| 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) |
30 |
24 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
149 |
143 |
$778.26 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
91 |
77 |
$396.98 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
817 |
713 |
$149.97 |
| A7002 |
Tubing, used with suction pump, each |
53 |
39 |
$106.58 |
| A7000 |
Canister, disposable, used with suction pump, each |
21 |
14 |
$103.20 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
14 |
13 |
$50.29 |