| 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 |
4,280 |
3,719 |
$202K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
738 |
699 |
$74K |
| E0277 |
Powered pressure-reducing air mattress |
229 |
198 |
$52K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,421 |
2,042 |
$45K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,194 |
1,009 |
$40K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,512 |
1,302 |
$25K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,447 |
2,142 |
$22K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,369 |
1,133 |
$17K |
| E0570 |
Nebulizer, with compressor |
1,396 |
1,316 |
$15K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
107 |
99 |
$13K |
| A7031 |
Face mask interface, replacement for full face mask, each |
902 |
775 |
$12K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
558 |
464 |
$10K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
237 |
206 |
$10K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
751 |
634 |
$9K |
| A7035 |
Headgear used with positive airway pressure device |
1,152 |
961 |
$9K |
| A7037 |
Tubing used with positive airway pressure device |
1,020 |
873 |
$6K |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
86 |
79 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,161 |
1,838 |
$4K |
| K0003 |
Lightweight wheelchair |
210 |
182 |
$4K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
256 |
227 |
$4K |
| E1399 |
Durable medical equipment, miscellaneous |
43 |
37 |
$3K |
| K0001 |
Standard wheelchair |
265 |
239 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
485 |
425 |
$2K |
| E1392 |
Portable oxygen concentrator, rental |
120 |
115 |
$922.43 |
| 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) |
13 |
13 |
$760.14 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
60 |
55 |
$682.49 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
40 |
37 |
$236.86 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
47 |
41 |
$200.21 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
13 |
12 |
$188.07 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
31 |
25 |
$102.57 |