| 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 |
15,380 |
13,201 |
$429K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,442 |
6,543 |
$199K |
| E0601 |
Continuous positive airway pressure (cpap) device |
6,448 |
5,756 |
$130K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,981 |
1,651 |
$112K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,590 |
1,379 |
$71K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,491 |
1,270 |
$57K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,558 |
1,987 |
$50K |
| A7035 |
Headgear used with positive airway pressure device |
2,357 |
2,016 |
$37K |
| 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) |
1,029 |
837 |
$33K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,371 |
1,956 |
$31K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,198 |
1,039 |
$27K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
369 |
317 |
$27K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
734 |
556 |
$25K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,602 |
4,397 |
$21K |
| E0570 |
Nebulizer, with compressor |
1,962 |
1,772 |
$13K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
167 |
165 |
$12K |
| K0001 |
Standard wheelchair |
1,532 |
1,208 |
$12K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,326 |
1,145 |
$10K |
| A7037 |
Tubing used with positive airway pressure device |
524 |
445 |
$9K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
905 |
654 |
$9K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
771 |
547 |
$8K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
993 |
831 |
$7K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
787 |
646 |
$4K |
| E1392 |
Portable oxygen concentrator, rental |
717 |
624 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
45 |
38 |
$1K |
| K0002 |
Standard hemi (low seat) wheelchair |
84 |
49 |
$914.98 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
53 |
38 |
$698.94 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
318 |
266 |
$387.53 |