| 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 |
21,883 |
16,478 |
$857K |
| E0601 |
Continuous positive airway pressure (cpap) device |
9,639 |
7,827 |
$296K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
784 |
634 |
$199K |
| E0570 |
Nebulizer, with compressor |
10,461 |
7,496 |
$154K |
| 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) |
2,288 |
1,756 |
$125K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,605 |
8,693 |
$94K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,545 |
1,230 |
$91K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
5,852 |
4,795 |
$89K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,183 |
1,740 |
$52K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,616 |
1,227 |
$41K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
826 |
686 |
$34K |
| E1392 |
Portable oxygen concentrator, rental |
2,432 |
1,779 |
$33K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
3,006 |
2,356 |
$31K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,150 |
802 |
$28K |
| A7035 |
Headgear used with positive airway pressure device |
2,305 |
1,802 |
$26K |
| E1140 |
Wheelchair, detachable arms, desk or full length, swing away detachable footrests |
754 |
622 |
$25K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
553 |
466 |
$21K |
| E1086 |
Hemi-wheelchair detachable arms desk or full length, swing away detachable footrests |
434 |
403 |
$18K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
846 |
559 |
$16K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,949 |
3,071 |
$13K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
404 |
342 |
$12K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
416 |
291 |
$12K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,037 |
823 |
$9K |
| A7037 |
Tubing used with positive airway pressure device |
709 |
568 |
$7K |
| 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 |
917 |
702 |
$6K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,432 |
1,091 |
$5K |
| E0184 |
Dry pressure mattress |
401 |
255 |
$4K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
88 |
38 |
$2K |
| K0001 |
Standard wheelchair |
664 |
522 |
$2K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
40 |
25 |
$2K |
| E1093 |
Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests |
43 |
38 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,970 |
1,470 |
$965.34 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
34 |
12 |
$909.44 |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,081 |
870 |
$906.23 |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
16 |
12 |
$710.20 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
71 |
26 |
$602.27 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
15 |
13 |
$392.47 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
16 |
12 |
$293.63 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
27 |
12 |
$271.84 |
| E0156 |
Seat attachment, walker |
39 |
25 |
$192.85 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
19 |
13 |
$76.88 |
| A4649 |
Surgical supply; miscellaneous |
16 |
13 |
$56.25 |
| K0002 |
Standard hemi (low seat) wheelchair |
536 |
404 |
$0.00 |