| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
26,512 |
23,331 |
$1.99M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,890 |
1,707 |
$734K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
13,939 |
12,352 |
$207K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,321 |
3,957 |
$181K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,027 |
1,837 |
$141K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,803 |
4,368 |
$82K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,919 |
1,710 |
$56K |
| 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) |
490 |
428 |
$56K |
| A7035 |
Headgear used with positive airway pressure device |
2,221 |
1,985 |
$36K |
| A7037 |
Tubing used with positive airway pressure device |
2,487 |
2,166 |
$33K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
6,171 |
5,548 |
$32K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
948 |
804 |
$32K |
| E0570 |
Nebulizer, with compressor |
3,162 |
2,717 |
$27K |
| K0001 |
Standard wheelchair |
930 |
832 |
$23K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,085 |
1,887 |
$19K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
352 |
319 |
$15K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
629 |
599 |
$13K |
| E1392 |
Portable oxygen concentrator, rental |
1,303 |
1,179 |
$10K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
249 |
231 |
$9K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
72 |
65 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
241 |
208 |
$2K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
115 |
98 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,366 |
1,113 |
$884.20 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
14 |
12 |
$3.26 |