| 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 |
23,151 |
20,180 |
$1.05M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,101 |
1,732 |
$764K |
| E2402 |
Negative pressure wound therapy electrical pump, stationary or portable |
574 |
478 |
$233K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
18,752 |
15,953 |
$113K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,444 |
2,243 |
$95K |
| A7030 |
Full face mask used with positive airway pressure device, each |
839 |
696 |
$43K |
| A6550 |
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories |
386 |
242 |
$32K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,331 |
1,157 |
$24K |
| E0570 |
Nebulizer, with compressor |
2,857 |
2,493 |
$18K |
| A7037 |
Tubing used with positive airway pressure device |
1,614 |
1,381 |
$17K |
| K0001 |
Standard wheelchair |
1,899 |
1,604 |
$17K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
352 |
335 |
$14K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
458 |
356 |
$9K |
| A7035 |
Headgear used with positive airway pressure device |
804 |
675 |
$9K |
| A7000 |
Canister, disposable, used with suction pump, each |
466 |
301 |
$9K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,294 |
1,761 |
$7K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
144 |
116 |
$5K |
| A7031 |
Face mask interface, replacement for full face mask, each |
284 |
166 |
$4K |
| E1392 |
Portable oxygen concentrator, rental |
646 |
588 |
$3K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
572 |
464 |
$2K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
46 |
38 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
156 |
137 |
$1K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
77 |
39 |
$864.17 |
| 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) |
13 |
12 |
$847.49 |
| A4452 |
Tape, waterproof, per 18 square inches |
34 |
27 |
$392.72 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
14 |
13 |
$374.56 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
53 |
40 |
$357.28 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
53 |
42 |
$301.00 |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
44 |
42 |
$0.00 |