| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
3,156 |
2,443 |
$148K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,009 |
1,431 |
$120K |
| E0570 |
Nebulizer, with compressor |
572 |
530 |
$58K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,912 |
1,349 |
$49K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,348 |
1,294 |
$31K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
685 |
666 |
$24K |
| A7030 |
Full face mask used with positive airway pressure device, each |
302 |
227 |
$23K |
| A7035 |
Headgear used with positive airway pressure device |
1,221 |
899 |
$18K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
415 |
283 |
$17K |
| 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 |
846 |
567 |
$12K |
| A7031 |
Face mask interface, replacement for full face mask, each |
297 |
234 |
$10K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
422 |
319 |
$7K |
| A7037 |
Tubing used with positive airway pressure device |
321 |
244 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,151 |
1,567 |
$7K |
| A4554 |
Disposable underpads, all sizes |
131 |
111 |
$6K |
| K0001 |
Standard wheelchair |
593 |
362 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
60 |
54 |
$598.37 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
17 |
14 |
$588.17 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
32 |
27 |
$241.67 |