| 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 |
1,174 |
918 |
$15K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,243 |
1,012 |
$14K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,221 |
998 |
$13K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
583 |
457 |
$8K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
933 |
779 |
$8K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,153 |
948 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,180 |
1,807 |
$4K |
| A7035 |
Headgear used with positive airway pressure device |
1,228 |
1,022 |
$4K |
| E0601 |
Continuous positive airway pressure (cpap) device |
603 |
480 |
$3K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
222 |
190 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
998 |
824 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,077 |
903 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
437 |
352 |
$2K |
| 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) |
50 |
50 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
841 |
720 |
$842.64 |
| A7036 |
Chinstrap used with positive airway pressure device |
12 |
12 |
$3.77 |