| 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 |
3,141 |
2,998 |
$198K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,406 |
1,394 |
$170K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,687 |
2,616 |
$142K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,261 |
1,217 |
$95K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,185 |
3,077 |
$92K |
| 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) |
730 |
705 |
$79K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,463 |
1,420 |
$53K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,948 |
1,883 |
$50K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
955 |
939 |
$45K |
| E0570 |
Nebulizer, with compressor |
754 |
743 |
$42K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
331 |
316 |
$36K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
67 |
63 |
$28K |
| K0001 |
Standard wheelchair |
948 |
931 |
$23K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
871 |
849 |
$21K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,613 |
5,428 |
$21K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,557 |
1,467 |
$20K |
| A7035 |
Headgear used with positive airway pressure device |
1,356 |
1,311 |
$20K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
313 |
313 |
$17K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
383 |
373 |
$9K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,115 |
1,075 |
$9K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
127 |
121 |
$7K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
820 |
796 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
893 |
880 |
$5K |
| A7037 |
Tubing used with positive airway pressure device |
196 |
192 |
$3K |
| K0003 |
Lightweight wheelchair |
56 |
55 |
$2K |
| E1392 |
Portable oxygen concentrator, rental |
170 |
165 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
120 |
118 |
$2K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
44 |
44 |
$1K |
| 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 |
43 |
43 |
$675.52 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
107 |
105 |
$43.24 |
| A7002 |
Tubing, used with suction pump, each |
16 |
16 |
$29.82 |