| 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 |
10,669 |
10,646 |
$522K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,008 |
2,993 |
$145K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,689 |
3,686 |
$119K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,397 |
4,355 |
$117K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,682 |
5,671 |
$59K |
| E1392 |
Portable oxygen concentrator, rental |
1,960 |
1,958 |
$47K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,909 |
3,904 |
$37K |
| A7035 |
Headgear used with positive airway pressure device |
2,841 |
2,827 |
$32K |
| A7037 |
Tubing used with positive airway pressure device |
3,242 |
3,230 |
$23K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,071 |
7,020 |
$19K |
| E0570 |
Nebulizer, with compressor |
2,269 |
2,266 |
$14K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
285 |
284 |
$8K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
203 |
201 |
$5K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,237 |
1,233 |
$4K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
391 |
391 |
$4K |
| K0001 |
Standard wheelchair |
174 |
174 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
133 |
132 |
$652.84 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
219 |
207 |
$269.34 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
12 |
12 |
$10.46 |