| 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 |
13,893 |
13,681 |
$923K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,538 |
4,495 |
$351K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
576 |
568 |
$175K |
| 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 |
7,920 |
7,800 |
$126K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,001 |
1,984 |
$121K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
469 |
468 |
$62K |
| K0001 |
Standard wheelchair |
2,872 |
2,841 |
$42K |
| A4554 |
Disposable underpads, all sizes |
1,101 |
1,075 |
$40K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,201 |
2,174 |
$35K |
| E0570 |
Nebulizer, with compressor |
1,321 |
1,252 |
$35K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,076 |
1,014 |
$28K |
| A7035 |
Headgear used with positive airway pressure device |
2,028 |
2,006 |
$23K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,271 |
3,164 |
$16K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
439 |
434 |
$11K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
225 |
221 |
$7K |
| E1392 |
Portable oxygen concentrator, rental |
1,206 |
1,171 |
$7K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,566 |
1,550 |
$6K |
| A4335 |
Incontinence supply; miscellaneous |
1,105 |
1,077 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
146 |
145 |
$4K |
| 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) |
52 |
51 |
$4K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
210 |
210 |
$3K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
13 |
13 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
215 |
209 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
83 |
72 |
$1K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
43 |
40 |
$554.73 |
| A7015 |
Aerosol mask, used with dme nebulizer |
190 |
190 |
$209.49 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
24 |
24 |
$93.84 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
12 |
12 |
$32.79 |