| 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 |
3,861 |
3,586 |
$374K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,252 |
2,928 |
$174K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
1,114 |
1,091 |
$136K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,754 |
3,391 |
$73K |
| A7030 |
Full face mask used with positive airway pressure device, each |
571 |
505 |
$60K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,220 |
2,101 |
$32K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
982 |
900 |
$30K |
| A7035 |
Headgear used with positive airway pressure device |
1,051 |
966 |
$23K |
| 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) |
135 |
125 |
$21K |
| E0570 |
Nebulizer, with compressor |
234 |
207 |
$19K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
849 |
514 |
$15K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
116 |
103 |
$8K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,366 |
1,269 |
$8K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
13 |
13 |
$8K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
518 |
462 |
$6K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
76 |
67 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,439 |
1,413 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
762 |
665 |
$3K |
| A4670 |
Automatic blood pressure monitor |
30 |
30 |
$2K |
| A7031 |
Face mask interface, replacement for full face mask, each |
14 |
13 |
$391.67 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
34 |
28 |
$326.65 |
| A7015 |
Aerosol mask, used with dme nebulizer |
140 |
127 |
$188.95 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
144 |
121 |
$110.73 |