| 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 |
7,299 |
6,230 |
$216K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
290 |
248 |
$84K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,616 |
2,287 |
$56K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,830 |
1,600 |
$48K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,893 |
1,583 |
$48K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,387 |
5,465 |
$46K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,884 |
3,323 |
$32K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,396 |
1,163 |
$16K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
804 |
697 |
$15K |
| A7037 |
Tubing used with positive airway pressure device |
2,302 |
2,018 |
$14K |
| K0001 |
Standard wheelchair |
879 |
773 |
$12K |
| A7035 |
Headgear used with positive airway pressure device |
1,275 |
1,090 |
$10K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
157 |
138 |
$5K |
| E0570 |
Nebulizer, with compressor |
761 |
643 |
$3K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
75 |
66 |
$3K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
63 |
56 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
44 |
39 |
$928.35 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
127 |
104 |
$849.81 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
65 |
49 |
$624.17 |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
30 |
24 |
$0.00 |