| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
618 |
461 |
$244K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,805 |
3,950 |
$169K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,903 |
2,534 |
$128K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
591 |
555 |
$110K |
| 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 |
3,285 |
2,794 |
$61K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,710 |
1,421 |
$49K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,635 |
2,269 |
$44K |
| A7030 |
Full face mask used with positive airway pressure device, each |
889 |
733 |
$43K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
813 |
718 |
$36K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,042 |
838 |
$35K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,498 |
1,175 |
$33K |
| K0001 |
Standard wheelchair |
2,615 |
2,080 |
$25K |
| A7035 |
Headgear used with positive airway pressure device |
1,322 |
1,147 |
$18K |
| E0570 |
Nebulizer, with compressor |
1,275 |
996 |
$16K |
| A7037 |
Tubing used with positive airway pressure device |
1,602 |
1,407 |
$16K |
| 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) |
129 |
107 |
$12K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,185 |
2,616 |
$12K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,124 |
981 |
$9K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
324 |
265 |
$8K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
266 |
221 |
$6K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,239 |
991 |
$6K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,189 |
1,048 |
$6K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
145 |
117 |
$3K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
291 |
269 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
90 |
80 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
48 |
40 |
$1K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
797 |
339 |
$968.14 |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
33 |
27 |
$660.78 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
19 |
12 |
$212.91 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
13 |
12 |
$209.27 |
| A7036 |
Chinstrap used with positive airway pressure device |
25 |
15 |
$117.67 |