| 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 |
13,125 |
11,830 |
$454K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,564 |
1,246 |
$394K |
| E0601 |
Continuous positive airway pressure (cpap) device |
12,872 |
11,585 |
$327K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,514 |
4,034 |
$171K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,343 |
3,034 |
$165K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
9,432 |
8,564 |
$128K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
4,091 |
3,667 |
$121K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
9,072 |
7,316 |
$62K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,931 |
2,561 |
$60K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,441 |
2,041 |
$58K |
| A7035 |
Headgear used with positive airway pressure device |
4,975 |
4,526 |
$56K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,968 |
2,727 |
$55K |
| 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) |
791 |
685 |
$37K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,175 |
2,000 |
$36K |
| A7037 |
Tubing used with positive airway pressure device |
4,128 |
3,726 |
$35K |
| E1392 |
Portable oxygen concentrator, rental |
1,332 |
1,187 |
$26K |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
2,187 |
1,808 |
$23K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,783 |
1,610 |
$22K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,073 |
888 |
$19K |
| E0570 |
Nebulizer, with compressor |
2,127 |
1,969 |
$14K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,209 |
1,099 |
$13K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
102 |
84 |
$12K |
| K0001 |
Standard wheelchair |
1,265 |
1,165 |
$12K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
120 |
105 |
$5K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
499 |
446 |
$5K |
| A7036 |
Chinstrap used with positive airway pressure device |
574 |
522 |
$5K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
324 |
288 |
$2K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
17 |
12 |
$926.93 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
162 |
147 |
$796.79 |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
19 |
13 |
$648.19 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
41 |
38 |
$583.60 |
| A4452 |
Tape, waterproof, per 18 square inches |
30 |
27 |
$299.85 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
13 |
13 |
$23.63 |