| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
4,235 |
3,720 |
$259K |
| 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) |
1,900 |
1,641 |
$206K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,281 |
1,868 |
$190K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,228 |
1,837 |
$134K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,547 |
1,889 |
$123K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,228 |
2,718 |
$101K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,631 |
1,407 |
$96K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
934 |
793 |
$85K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,999 |
3,369 |
$55K |
| A7035 |
Headgear used with positive airway pressure device |
2,318 |
1,961 |
$44K |
| K0001 |
Standard wheelchair |
1,347 |
976 |
$21K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
694 |
450 |
$20K |
| A4927 |
Gloves, non-sterile, per 100 |
1,578 |
1,155 |
$20K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
422 |
366 |
$14K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,878 |
1,622 |
$14K |
| T4541 |
Incontinence product, disposable underpad, large, each |
821 |
646 |
$14K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
144 |
131 |
$10K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
47 |
42 |
$7K |
| E1392 |
Portable oxygen concentrator, rental |
160 |
157 |
$2K |
| E0570 |
Nebulizer, with compressor |
49 |
37 |
$1K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
153 |
120 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
46 |
39 |
$790.75 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
407 |
219 |
$0.00 |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
163 |
148 |
$0.00 |