| 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 |
19,356 |
17,944 |
$744K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
10,384 |
9,639 |
$305K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,361 |
2,124 |
$50K |
| A7030 |
Full face mask used with positive airway pressure device, each |
778 |
659 |
$25K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,111 |
935 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,245 |
3,747 |
$14K |
| A7037 |
Tubing used with positive airway pressure device |
2,115 |
1,827 |
$12K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
852 |
745 |
$11K |
| A7035 |
Headgear used with positive airway pressure device |
706 |
597 |
$5K |
| E0570 |
Nebulizer, with compressor |
437 |
369 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
367 |
313 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
40 |
38 |
$873.58 |
| 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) |
17 |
12 |
$543.60 |
| A4452 |
Tape, waterproof, per 18 square inches |
131 |
113 |
$302.78 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
13 |
12 |
$219.39 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
33 |
25 |
$175.30 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
53 |
41 |
$68.94 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
15 |
14 |
$26.42 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
15 |
12 |
$21.21 |