| 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 |
5,754 |
4,976 |
$156K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,381 |
1,184 |
$62K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,180 |
2,659 |
$59K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,339 |
2,011 |
$51K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,408 |
2,053 |
$18K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,968 |
2,560 |
$17K |
| A7035 |
Headgear used with positive airway pressure device |
1,162 |
982 |
$11K |
| E1392 |
Portable oxygen concentrator, rental |
1,128 |
948 |
$11K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
434 |
373 |
$10K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
533 |
420 |
$10K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,903 |
3,244 |
$10K |
| A7037 |
Tubing used with positive airway pressure device |
1,160 |
1,009 |
$8K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
247 |
203 |
$7K |
| K0003 |
Lightweight wheelchair |
612 |
523 |
$7K |
| E0570 |
Nebulizer, with compressor |
1,228 |
1,127 |
$4K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
245 |
210 |
$4K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
373 |
293 |
$3K |
| K0001 |
Standard wheelchair |
542 |
432 |
$3K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
235 |
221 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
391 |
325 |
$2K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
221 |
190 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
603 |
510 |
$2K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
267 |
100 |
$370.84 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
483 |
205 |
$201.36 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
172 |
81 |
$56.77 |