| 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 |
5,364 |
4,683 |
$409K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,428 |
2,212 |
$36K |
| E1392 |
Portable oxygen concentrator, rental |
767 |
664 |
$11K |
| A7030 |
Full face mask used with positive airway pressure device, each |
180 |
134 |
$8K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,201 |
1,037 |
$6K |
| A7031 |
Face mask interface, replacement for full face mask, each |
186 |
136 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
212 |
167 |
$3K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
182 |
132 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
69 |
47 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
75 |
62 |
$948.45 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
138 |
105 |
$884.61 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
88 |
66 |
$549.91 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
19 |
13 |
$321.28 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
50 |
44 |
$275.79 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
22 |
13 |
$149.90 |