| 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 |
7,783 |
7,326 |
$344K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,623 |
2,434 |
$113K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,195 |
3,976 |
$109K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,049 |
3,619 |
$109K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,973 |
2,786 |
$61K |
| E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
1,487 |
1,410 |
$54K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,248 |
4,121 |
$50K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,947 |
1,785 |
$41K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,863 |
2,699 |
$30K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,512 |
1,396 |
$27K |
| A7035 |
Headgear used with positive airway pressure device |
2,546 |
2,359 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
6,790 |
6,302 |
$19K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
2,056 |
1,915 |
$17K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
922 |
845 |
$16K |
| A7037 |
Tubing used with positive airway pressure device |
1,621 |
1,492 |
$11K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,034 |
1,861 |
$9K |
| E1392 |
Portable oxygen concentrator, rental |
125 |
123 |
$3K |
| K0001 |
Standard wheelchair |
199 |
192 |
$2K |
| E0570 |
Nebulizer, with compressor |
305 |
301 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
739 |
681 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
13 |
13 |
$503.03 |