| 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 |
1,700 |
1,641 |
$124K |
| A7030 |
Full face mask used with positive airway pressure device, each |
910 |
866 |
$76K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,216 |
1,150 |
$41K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
770 |
738 |
$28K |
| A7031 |
Face mask interface, replacement for full face mask, each |
742 |
697 |
$23K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,952 |
1,823 |
$22K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
154 |
132 |
$18K |
| A7035 |
Headgear used with positive airway pressure device |
741 |
688 |
$13K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,975 |
1,851 |
$9K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
122 |
113 |
$7K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
43 |
43 |
$6K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
468 |
455 |
$4K |
| K0001 |
Standard wheelchair |
188 |
174 |
$3K |
| 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) |
55 |
53 |
$2K |
| E0570 |
Nebulizer, with compressor |
100 |
87 |
$1K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
28 |
24 |
$1K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
106 |
102 |
$964.12 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
52 |
50 |
$771.18 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
12 |
12 |
$324.93 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
60 |
53 |
$63.73 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
16 |
13 |
$35.33 |