| 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 |
7,744 |
7,113 |
$428K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,349 |
1,168 |
$93K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,822 |
1,575 |
$78K |
| 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 |
3,624 |
3,344 |
$55K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
157 |
142 |
$50K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,516 |
1,292 |
$47K |
| 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) |
443 |
400 |
$31K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
926 |
757 |
$30K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
604 |
501 |
$27K |
| E0570 |
Nebulizer, with compressor |
1,834 |
1,510 |
$21K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,074 |
1,934 |
$21K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
446 |
347 |
$20K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
481 |
418 |
$20K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
303 |
250 |
$19K |
| K0003 |
Lightweight wheelchair |
388 |
328 |
$16K |
| A7035 |
Headgear used with positive airway pressure device |
1,128 |
981 |
$14K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,363 |
2,009 |
$11K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
261 |
231 |
$11K |
| A7037 |
Tubing used with positive airway pressure device |
1,048 |
932 |
$10K |
| E1392 |
Portable oxygen concentrator, rental |
471 |
397 |
$7K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
246 |
241 |
$7K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
685 |
542 |
$7K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,044 |
900 |
$6K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
103 |
82 |
$4K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
207 |
170 |
$3K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
297 |
174 |
$3K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
86 |
68 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
408 |
344 |
$2K |
| K0001 |
Standard wheelchair |
123 |
123 |
$1K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
16 |
12 |
$28.74 |