| 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 |
14,985 |
13,894 |
$533K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,283 |
1,140 |
$465K |
| E0601 |
Continuous positive airway pressure (cpap) device |
9,696 |
8,542 |
$336K |
| A7031 |
Face mask interface, replacement for full face mask, each |
8,300 |
7,697 |
$220K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
7,071 |
6,673 |
$197K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,915 |
3,610 |
$171K |
| 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) |
2,140 |
1,934 |
$137K |
| E1392 |
Portable oxygen concentrator, rental |
6,966 |
6,472 |
$108K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
10,142 |
8,782 |
$106K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,346 |
2,186 |
$94K |
| E0570 |
Nebulizer, with compressor |
2,359 |
2,179 |
$68K |
| A7035 |
Headgear used with positive airway pressure device |
3,783 |
3,548 |
$47K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
15,315 |
14,291 |
$46K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,694 |
4,290 |
$38K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,619 |
1,506 |
$29K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,354 |
1,223 |
$27K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,839 |
2,680 |
$26K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
694 |
663 |
$23K |
| K0001 |
Standard wheelchair |
2,148 |
1,959 |
$20K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
470 |
440 |
$12K |
| A7037 |
Tubing used with positive airway pressure device |
713 |
661 |
$7K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,208 |
1,115 |
$4K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
203 |
195 |
$4K |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
1,068 |
1,001 |
$2K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
37 |
36 |
$947.29 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
94 |
82 |
$393.48 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
19 |
12 |
$342.75 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
12 |
12 |
$280.82 |