| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
257 |
257 |
$28K |
| E0570 |
Nebulizer, with compressor |
58 |
58 |
$5K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
164 |
163 |
$4K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
28 |
28 |
$4K |
| A7035 |
Headgear used with positive airway pressure device |
45 |
45 |
$568.15 |
| A7037 |
Tubing used with positive airway pressure device |
62 |
62 |
$509.40 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
32 |
32 |
$440.32 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
12 |
12 |
$252.03 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
28 |
25 |
$172.00 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
39 |
39 |
$72.50 |
| A7015 |
Aerosol mask, used with dme nebulizer |
25 |
25 |
$23.40 |