| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,542 |
1,341 |
$253K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,390 |
2,980 |
$116K |
| E0570 |
Nebulizer, with compressor |
1,740 |
1,530 |
$101K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,368 |
2,932 |
$100K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,790 |
2,395 |
$62K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,464 |
1,257 |
$55K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,363 |
2,006 |
$49K |
| 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) |
651 |
580 |
$46K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,182 |
1,020 |
$37K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,454 |
2,955 |
$35K |
| A7035 |
Headgear used with positive airway pressure device |
2,245 |
1,927 |
$23K |
| K0001 |
Standard wheelchair |
2,461 |
1,991 |
$22K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,768 |
1,588 |
$14K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,087 |
3,301 |
$10K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
695 |
657 |
$7K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
898 |
767 |
$6K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
233 |
209 |
$6K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
306 |
263 |
$5K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
365 |
302 |
$4K |
| A7037 |
Tubing used with positive airway pressure device |
440 |
381 |
$3K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
843 |
732 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
365 |
354 |
$70.69 |