| 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 |
1,034 |
1,032 |
$71K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,636 |
1,597 |
$57K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
318 |
318 |
$38K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
67 |
67 |
$13K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
676 |
668 |
$11K |
| K0003 |
Lightweight wheelchair |
215 |
215 |
$9K |
| A4927 |
Gloves, non-sterile, per 100 |
227 |
214 |
$8K |
| A7030 |
Full face mask used with positive airway pressure device, each |
113 |
109 |
$5K |
| K0001 |
Standard wheelchair |
190 |
188 |
$3K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
53 |
53 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
218 |
214 |
$3K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
29 |
28 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
362 |
358 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
168 |
168 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
102 |
100 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
43 |
43 |
$830.90 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
13 |
13 |
$716.68 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
14 |
12 |
$714.96 |
| A7031 |
Face mask interface, replacement for full face mask, each |
39 |
37 |
$690.63 |
| A7000 |
Canister, disposable, used with suction pump, each |
86 |
81 |
$410.03 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
12 |
12 |
$68.13 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
12 |
12 |
$57.74 |