| 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 |
8,039 |
6,101 |
$561K |
| E0570 |
Nebulizer, with compressor |
6,087 |
4,645 |
$389K |
| E0601 |
Continuous positive airway pressure (cpap) device |
6,978 |
5,427 |
$337K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,055 |
1,447 |
$133K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,415 |
3,250 |
$125K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,141 |
1,547 |
$96K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
1,938 |
1,664 |
$86K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,990 |
2,920 |
$74K |
| A7037 |
Tubing used with positive airway pressure device |
3,123 |
2,216 |
$48K |
| A7035 |
Headgear used with positive airway pressure device |
3,341 |
2,424 |
$48K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,595 |
1,058 |
$45K |
| 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) |
419 |
323 |
$40K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,616 |
1,126 |
$35K |
| E1392 |
Portable oxygen concentrator, rental |
1,577 |
1,221 |
$33K |
| K0001 |
Standard wheelchair |
1,752 |
1,238 |
$23K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,780 |
3,401 |
$14K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
780 |
597 |
$12K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
660 |
570 |
$8K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
381 |
276 |
$8K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
69 |
55 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
635 |
459 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
139 |
116 |
$2K |
| A7036 |
Chinstrap used with positive airway pressure device |
34 |
24 |
$277.01 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
12 |
12 |
$102.22 |