| 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 |
17,710 |
17,644 |
$858K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
10,837 |
10,820 |
$100K |
| E0570 |
Nebulizer, with compressor |
4,512 |
4,505 |
$58K |
| E1392 |
Portable oxygen concentrator, rental |
2,116 |
2,107 |
$35K |
| A7031 |
Face mask interface, replacement for full face mask, each |
963 |
960 |
$22K |
| A7030 |
Full face mask used with positive airway pressure device, each |
530 |
529 |
$21K |
| E0601 |
Continuous positive airway pressure (cpap) device |
593 |
591 |
$15K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
361 |
360 |
$9K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
405 |
403 |
$8K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
438 |
435 |
$6K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
730 |
726 |
$6K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
239 |
237 |
$5K |
| A7037 |
Tubing used with positive airway pressure device |
866 |
862 |
$4K |
| A7035 |
Headgear used with positive airway pressure device |
576 |
574 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,150 |
2,139 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,880 |
1,831 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
417 |
417 |
$1K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
95 |
95 |
$435.28 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
12 |
12 |
$150.92 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
32 |
32 |
$73.64 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
28 |
28 |
$2.56 |