| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,210 |
684 |
$193K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,202 |
3,425 |
$168K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,677 |
3,115 |
$139K |
| 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) |
512 |
431 |
$50K |
| A7030 |
Full face mask used with positive airway pressure device, each |
704 |
585 |
$45K |
| A7037 |
Tubing used with positive airway pressure device |
1,959 |
1,603 |
$27K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,113 |
799 |
$25K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
595 |
497 |
$22K |
| A7035 |
Headgear used with positive airway pressure device |
1,090 |
887 |
$14K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,550 |
2,464 |
$14K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
126 |
100 |
$12K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,595 |
2,014 |
$10K |
| K0004 |
High strength, lightweight wheelchair |
491 |
380 |
$9K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
448 |
359 |
$9K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
228 |
191 |
$6K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,749 |
644 |
$6K |
| K0001 |
Standard wheelchair |
294 |
220 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
487 |
363 |
$2K |
| E0570 |
Nebulizer, with compressor |
328 |
274 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
324 |
269 |
$1K |
| K0003 |
Lightweight wheelchair |
63 |
49 |
$953.57 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
107 |
65 |
$356.36 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
28 |
26 |
$80.18 |
| K0052 |
Swingaway, detachable footrests, replacement only, each |
125 |
43 |
$13.28 |