| 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 |
12,819 |
11,089 |
$390K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,290 |
957 |
$386K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,414 |
5,575 |
$73K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,823 |
2,530 |
$67K |
| 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) |
867 |
768 |
$53K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,125 |
1,019 |
$35K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
819 |
712 |
$31K |
| 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 |
2,733 |
2,270 |
$26K |
| E0570 |
Nebulizer, with compressor |
1,446 |
1,335 |
$22K |
| A7035 |
Headgear used with positive airway pressure device |
1,144 |
1,048 |
$12K |
| E1392 |
Portable oxygen concentrator, rental |
1,063 |
943 |
$10K |
| A7037 |
Tubing used with positive airway pressure device |
1,503 |
1,351 |
$10K |
| A7031 |
Face mask interface, replacement for full face mask, each |
730 |
641 |
$5K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
317 |
284 |
$5K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
798 |
721 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,404 |
2,148 |
$4K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
41 |
37 |
$848.79 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
45 |
40 |
$704.56 |
| K0001 |
Standard wheelchair |
41 |
39 |
$586.38 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
57 |
51 |
$542.74 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
64 |
64 |
$457.22 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
12 |
12 |
$120.49 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
14 |
14 |
$117.76 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
143 |
131 |
$106.42 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
139 |
135 |
$80.63 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
13 |
13 |
$56.80 |