| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer, with compressor |
3,552 |
3,381 |
$454K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,428 |
2,379 |
$166K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,228 |
1,189 |
$133K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,658 |
1,612 |
$86K |
| K0003 |
Lightweight wheelchair |
1,975 |
1,889 |
$59K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
1,593 |
1,545 |
$57K |
| 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) |
373 |
356 |
$39K |
| A7037 |
Tubing used with positive airway pressure device |
1,455 |
1,413 |
$33K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,452 |
3,361 |
$24K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
128 |
121 |
$22K |
| A7035 |
Headgear used with positive airway pressure device |
1,037 |
1,001 |
$21K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
303 |
288 |
$19K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
272 |
255 |
$11K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,017 |
892 |
$7K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,659 |
1,591 |
$7K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
104 |
104 |
$7K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
516 |
496 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
118 |
114 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,895 |
1,838 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,645 |
1,599 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
84 |
82 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
691 |
590 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
160 |
158 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
50 |
46 |
$1K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
28 |
27 |
$831.26 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
30 |
28 |
$633.08 |