| 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 |
8,842 |
8,010 |
$290K |
| E0601 |
Continuous positive airway pressure (cpap) device |
5,436 |
4,896 |
$186K |
| A7031 |
Face mask interface, replacement for full face mask, each |
6,006 |
5,667 |
$128K |
| 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) |
1,725 |
1,545 |
$120K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,862 |
4,469 |
$105K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,779 |
2,510 |
$104K |
| E0570 |
Nebulizer, with compressor |
3,287 |
2,962 |
$92K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,796 |
2,440 |
$73K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,493 |
1,397 |
$58K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,502 |
4,945 |
$41K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,256 |
1,130 |
$36K |
| A7035 |
Headgear used with positive airway pressure device |
4,055 |
3,680 |
$33K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
11,930 |
10,995 |
$27K |
| K0001 |
Standard wheelchair |
1,225 |
1,114 |
$20K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,929 |
1,772 |
$13K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
639 |
583 |
$5K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
583 |
536 |
$5K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,260 |
1,130 |
$4K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
292 |
268 |
$2K |
| E0627 |
Seat lift mechanism, electric, any type |
31 |
25 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
180 |
155 |
$1K |
| A4217 |
Sterile water/saline, 500 ml |
62 |
54 |
$159.20 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
106 |
90 |
$156.68 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
14 |
12 |
$85.87 |
| A9270 |
Non-covered item or service |
18 |
13 |
$0.00 |