| 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 |
3,875 |
2,886 |
$203K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,776 |
1,380 |
$65K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,162 |
822 |
$21K |
| K0001 |
Standard wheelchair |
2,797 |
2,036 |
$17K |
| A7030 |
Full face mask used with positive airway pressure device, each |
240 |
197 |
$14K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,565 |
1,194 |
$14K |
| E0570 |
Nebulizer, with compressor |
1,010 |
734 |
$14K |
| A7031 |
Face mask interface, replacement for full face mask, each |
439 |
317 |
$9K |
| E1392 |
Portable oxygen concentrator, rental |
552 |
415 |
$8K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
342 |
291 |
$5K |
| A7035 |
Headgear used with positive airway pressure device |
312 |
249 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,576 |
1,179 |
$4K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
73 |
64 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
13 |
12 |
$2K |
| A4670 |
Automatic blood pressure monitor |
22 |
15 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
96 |
72 |
$1K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
29 |
24 |
$677.92 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
57 |
51 |
$338.53 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
14 |
12 |
$257.25 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
16 |
12 |
$82.42 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
57 |
39 |
$47.44 |