| 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 |
4,360 |
4,076 |
$433K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,853 |
3,689 |
$173K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,042 |
987 |
$106K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,952 |
1,876 |
$66K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
912 |
856 |
$52K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,203 |
1,149 |
$50K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,105 |
1,044 |
$45K |
| E1392 |
Portable oxygen concentrator, rental |
1,122 |
1,023 |
$39K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
94 |
93 |
$31K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
123 |
120 |
$31K |
| 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) |
257 |
245 |
$29K |
| K0001 |
Standard wheelchair |
981 |
939 |
$27K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,196 |
1,157 |
$26K |
| E0570 |
Nebulizer, with compressor |
1,229 |
1,160 |
$23K |
| A7035 |
Headgear used with positive airway pressure device |
1,091 |
1,039 |
$23K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
245 |
238 |
$16K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,609 |
2,499 |
$14K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
149 |
143 |
$10K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
370 |
313 |
$6K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
387 |
367 |
$5K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
178 |
177 |
$5K |
| E1399 |
Durable medical equipment, miscellaneous |
15 |
12 |
$4K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
97 |
90 |
$4K |
| K0002 |
Standard hemi (low seat) wheelchair |
110 |
103 |
$3K |
| A4452 |
Tape, waterproof, per 18 square inches |
63 |
52 |
$1K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
26 |
26 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
13 |
13 |
$999.45 |
| A7037 |
Tubing used with positive airway pressure device |
43 |
41 |
$728.55 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
55 |
52 |
$447.49 |