| 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 |
3,830 |
3,744 |
$221K |
| E0601 |
Continuous positive airway pressure (cpap) device |
618 |
600 |
$40K |
| E0570 |
Nebulizer, with compressor |
819 |
812 |
$28K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,046 |
2,032 |
$26K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
875 |
858 |
$15K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
419 |
419 |
$14K |
| A7030 |
Full face mask used with positive airway pressure device, each |
212 |
211 |
$13K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
388 |
386 |
$4K |
| A7035 |
Headgear used with positive airway pressure device |
216 |
215 |
$2K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
481 |
410 |
$2K |
| 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) |
12 |
12 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
605 |
603 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
116 |
116 |
$1K |
| A7031 |
Face mask interface, replacement for full face mask, each |
12 |
12 |
$485.86 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
12 |
12 |
$86.65 |