| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,048 |
1,851 |
$379K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,681 |
4,999 |
$126K |
| E0483 |
High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each |
552 |
500 |
$93K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,091 |
1,824 |
$33K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,808 |
1,374 |
$23K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,411 |
1,054 |
$20K |
| A7030 |
Full face mask used with positive airway pressure device, each |
942 |
728 |
$18K |
| E1392 |
Portable oxygen concentrator, rental |
1,328 |
1,186 |
$12K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,828 |
2,450 |
$12K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
493 |
433 |
$8K |
| A7037 |
Tubing used with positive airway pressure device |
1,230 |
941 |
$7K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
415 |
385 |
$4K |
| K0003 |
Lightweight wheelchair |
309 |
256 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
676 |
536 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
669 |
531 |
$3K |
| E0570 |
Nebulizer, with compressor |
709 |
665 |
$2K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
733 |
360 |
$2K |
| K0001 |
Standard wheelchair |
191 |
162 |
$1K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
161 |
145 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
409 |
315 |
$842.75 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
63 |
49 |
$741.64 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
39 |
26 |
$317.42 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
368 |
164 |
$287.89 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
401 |
173 |
$156.45 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
70 |
62 |
$149.38 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
241 |
104 |
$38.67 |