| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
6,019 |
5,995 |
$69K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,476 |
3,466 |
$53K |
| 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) |
859 |
857 |
$32K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,138 |
3,124 |
$31K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,840 |
1,832 |
$29K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,136 |
2,103 |
$23K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,436 |
2,430 |
$17K |
| K0001 |
Standard wheelchair |
1,646 |
1,631 |
$9K |
| A7035 |
Headgear used with positive airway pressure device |
1,794 |
1,785 |
$7K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
620 |
619 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,781 |
3,683 |
$6K |
| E1392 |
Portable oxygen concentrator, rental |
2,476 |
2,471 |
$6K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
437 |
433 |
$5K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
186 |
185 |
$3K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
750 |
748 |
$2K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
175 |
173 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
600 |
596 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
678 |
675 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
683 |
682 |
$863.25 |
| A7045 |
Exhalation port with or without swivel used with accessories for positive airway devices, replacement only |
272 |
272 |
$818.76 |
| A7037 |
Tubing used with positive airway pressure device |
138 |
137 |
$719.16 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
88 |
88 |
$708.71 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
229 |
226 |
$542.77 |