| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
475 |
283 |
$73K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,711 |
2,556 |
$68K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,591 |
1,399 |
$66K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,002 |
1,811 |
$66K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
401 |
345 |
$58K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
706 |
660 |
$49K |
| E1399 |
Durable medical equipment, miscellaneous |
109 |
54 |
$48K |
| A7030 |
Full face mask used with positive airway pressure device, each |
853 |
753 |
$48K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,181 |
1,082 |
$38K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
744 |
648 |
$28K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
103 |
96 |
$27K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
311 |
276 |
$18K |
| A7035 |
Headgear used with positive airway pressure device |
1,090 |
971 |
$16K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,965 |
2,756 |
$15K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
486 |
461 |
$14K |
| E1392 |
Portable oxygen concentrator, rental |
681 |
585 |
$13K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
206 |
196 |
$12K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
77 |
76 |
$11K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
485 |
424 |
$6K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
104 |
103 |
$3K |
| E0570 |
Nebulizer, with compressor |
280 |
242 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
38 |
38 |
$2K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
29 |
28 |
$2K |
| K0040 |
Adjustable angle footplate, each |
27 |
27 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
31 |
31 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
12 |
12 |
$294.94 |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
12 |
12 |
$194.15 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
12 |
12 |
$151.31 |