| 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 |
5,539 |
5,524 |
$362K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,455 |
1,449 |
$75K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,918 |
3,907 |
$53K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,443 |
1,442 |
$48K |
| E0570 |
Nebulizer, with compressor |
4,407 |
4,388 |
$39K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,571 |
1,566 |
$28K |
| K0001 |
Standard wheelchair |
820 |
818 |
$21K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
356 |
353 |
$18K |
| A7030 |
Full face mask used with positive airway pressure device, each |
288 |
288 |
$16K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
547 |
544 |
$16K |
| A7035 |
Headgear used with positive airway pressure device |
871 |
871 |
$15K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,539 |
2,517 |
$12K |
| A7031 |
Face mask interface, replacement for full face mask, each |
211 |
209 |
$6K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
455 |
455 |
$4K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
634 |
634 |
$4K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
193 |
193 |
$3K |
| E1392 |
Portable oxygen concentrator, rental |
107 |
107 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
132 |
132 |
$2K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
31 |
31 |
$1K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
13 |
13 |
$434.88 |