| 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 |
6,032 |
5,283 |
$203K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,102 |
3,744 |
$166K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,670 |
2,451 |
$60K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,206 |
3,849 |
$50K |
| A7030 |
Full face mask used with positive airway pressure device, each |
699 |
632 |
$33K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,806 |
3,356 |
$32K |
| 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) |
360 |
351 |
$28K |
| K0001 |
Standard wheelchair |
1,007 |
798 |
$18K |
| A7035 |
Headgear used with positive airway pressure device |
1,448 |
1,329 |
$16K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
872 |
666 |
$15K |
| A7037 |
Tubing used with positive airway pressure device |
1,612 |
1,500 |
$13K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,862 |
3,553 |
$11K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
394 |
361 |
$8K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
263 |
217 |
$7K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
206 |
199 |
$6K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
891 |
833 |
$6K |
| E0570 |
Nebulizer, with compressor |
550 |
455 |
$5K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
110 |
107 |
$4K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
225 |
193 |
$3K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
127 |
124 |
$2K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
77 |
61 |
$2K |
| E1392 |
Portable oxygen concentrator, rental |
65 |
62 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
14 |
13 |
$315.61 |
| A7036 |
Chinstrap used with positive airway pressure device |
13 |
13 |
$109.38 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
27 |
14 |
$79.90 |