| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A7030 |
Full face mask used with positive airway pressure device, each |
355 |
341 |
$34K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
269 |
258 |
$27K |
| A7031 |
Face mask interface, replacement for full face mask, each |
353 |
332 |
$27K |
| 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) |
197 |
183 |
$26K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
716 |
681 |
$25K |
| E0601 |
Continuous positive airway pressure (cpap) device |
221 |
211 |
$24K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
368 |
351 |
$23K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
308 |
285 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
821 |
786 |
$10K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
122 |
119 |
$10K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
305 |
294 |
$9K |
| A7035 |
Headgear used with positive airway pressure device |
427 |
406 |
$9K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
61 |
57 |
$5K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
27 |
27 |
$5K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
77 |
69 |
$5K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
142 |
129 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
329 |
311 |
$3K |
| E0570 |
Nebulizer, with compressor |
93 |
87 |
$3K |
| T4541 |
Incontinence product, disposable underpad, large, each |
94 |
89 |
$2K |
| K0001 |
Standard wheelchair |
166 |
155 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
175 |
142 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
77 |
65 |
$1K |
| E1392 |
Portable oxygen concentrator, rental |
50 |
50 |
$840.32 |
| K0007 |
Extra heavy duty wheelchair |
12 |
12 |
$837.39 |