| 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 |
2,580 |
2,186 |
$88K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,349 |
2,058 |
$68K |
| E0570 |
Nebulizer, with compressor |
2,028 |
1,821 |
$27K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
943 |
813 |
$21K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
923 |
772 |
$18K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,579 |
1,307 |
$15K |
| A7031 |
Face mask interface, replacement for full face mask, each |
484 |
433 |
$14K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
296 |
252 |
$8K |
| A7030 |
Full face mask used with positive airway pressure device, each |
160 |
129 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
660 |
593 |
$8K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,503 |
1,347 |
$5K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
87 |
77 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
64 |
51 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
246 |
220 |
$2K |
| E1130 |
Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests |
98 |
88 |
$1K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
33 |
25 |
$255.66 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
49 |
38 |
$59.60 |
| K0001 |
Standard wheelchair |
47 |
38 |
$0.00 |
| 90688 |
|
50 |
50 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
75 |
73 |
$0.00 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
13 |
13 |
$0.00 |
| 90674 |
|
39 |
37 |
$0.00 |