| 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 |
9,022 |
8,573 |
$439K |
| A7030 |
Full face mask used with positive airway pressure device, each |
981 |
968 |
$83K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,963 |
1,872 |
$67K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,004 |
5,674 |
$44K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,593 |
1,555 |
$41K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
687 |
638 |
$36K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
523 |
505 |
$32K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,124 |
1,093 |
$29K |
| A7035 |
Headgear used with positive airway pressure device |
1,036 |
1,013 |
$16K |
| 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) |
149 |
139 |
$14K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
303 |
288 |
$13K |
| K0001 |
Standard wheelchair |
720 |
709 |
$11K |
| E0570 |
Nebulizer, with compressor |
1,234 |
1,196 |
$10K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
65 |
65 |
$9K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,267 |
2,197 |
$7K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
88 |
88 |
$6K |
| E1392 |
Portable oxygen concentrator, rental |
314 |
276 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
412 |
407 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
26 |
25 |
$1K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
12 |
12 |
$633.24 |
| A7036 |
Chinstrap used with positive airway pressure device |
42 |
41 |
$495.89 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
14 |
14 |
$265.17 |
| T4541 |
Incontinence product, disposable underpad, large, each |
13 |
13 |
$262.50 |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
12 |
12 |
$154.35 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
12 |
12 |
$10.04 |