| 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 |
28,174 |
19,346 |
$926K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
18,496 |
12,785 |
$116K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,651 |
1,954 |
$100K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,823 |
1,303 |
$79K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,648 |
1,273 |
$54K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,264 |
1,697 |
$49K |
| A7035 |
Headgear used with positive airway pressure device |
2,773 |
2,190 |
$37K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,288 |
947 |
$36K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,460 |
6,300 |
$35K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,325 |
1,024 |
$26K |
| A7037 |
Tubing used with positive airway pressure device |
2,367 |
1,720 |
$24K |
| E0570 |
Nebulizer, with compressor |
4,093 |
2,785 |
$23K |
| E1392 |
Portable oxygen concentrator, rental |
2,384 |
1,658 |
$23K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,009 |
779 |
$17K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,060 |
1,628 |
$13K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
334 |
274 |
$4K |
| K0001 |
Standard wheelchair |
270 |
191 |
$3K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
284 |
160 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,721 |
1,085 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
171 |
139 |
$948.60 |
| K0003 |
Lightweight wheelchair |
33 |
24 |
$165.35 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
13 |
13 |
$150.82 |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
18 |
13 |
$148.41 |
| A7002 |
Tubing, used with suction pump, each |
29 |
13 |
$113.27 |