| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,382 |
1,025 |
$425K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
9,886 |
8,377 |
$324K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,765 |
3,325 |
$121K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,671 |
3,200 |
$101K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,738 |
7,455 |
$70K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,302 |
1,162 |
$49K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,275 |
1,075 |
$38K |
| K0001 |
Standard wheelchair |
2,859 |
2,406 |
$37K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,117 |
936 |
$27K |
| 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) |
290 |
263 |
$24K |
| K0003 |
Lightweight wheelchair |
1,491 |
1,255 |
$24K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
743 |
696 |
$22K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
533 |
430 |
$21K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
641 |
393 |
$19K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
644 |
571 |
$17K |
| E0570 |
Nebulizer, with compressor |
1,176 |
952 |
$15K |
| A7031 |
Face mask interface, replacement for full face mask, each |
641 |
578 |
$15K |
| A7030 |
Full face mask used with positive airway pressure device, each |
293 |
261 |
$12K |
| E0135 |
Walker, folding (pickup), adjustable or fixed height |
526 |
415 |
$11K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
247 |
218 |
$9K |
| A7035 |
Headgear used with positive airway pressure device |
654 |
591 |
$8K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
244 |
214 |
$7K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
60 |
54 |
$5K |
| E0156 |
Seat attachment, walker |
648 |
551 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,310 |
1,181 |
$3K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
298 |
215 |
$3K |
| E1392 |
Portable oxygen concentrator, rental |
206 |
151 |
$3K |
| K0004 |
High strength, lightweight wheelchair |
214 |
194 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
100 |
91 |
$889.43 |
| E0148 |
Walker, heavy duty, without wheels, rigid or folding, any type, each |
12 |
12 |
$436.73 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
109 |
86 |
$355.97 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
23 |
12 |
$329.84 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
14 |
14 |
$225.18 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
15 |
12 |
$199.42 |
| E0155 |
Wheel attachment, rigid pick-up walker, per pair |
22 |
19 |
$134.34 |
| A7037 |
Tubing used with positive airway pressure device |
15 |
12 |
$120.29 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
15 |
13 |
$95.29 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
15 |
14 |
$10.83 |