| 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 |
5,895 |
5,489 |
$361K |
| A7030 |
Full face mask used with positive airway pressure device, each |
691 |
610 |
$59K |
| 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 |
1,610 |
1,512 |
$49K |
| E0441 |
Stationary oxygen contents, gaseous, 1 month's supply = 1 unit |
951 |
943 |
$46K |
| E0601 |
Continuous positive airway pressure (cpap) device |
914 |
770 |
$28K |
| A7031 |
Face mask interface, replacement for full face mask, each |
623 |
544 |
$23K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
319 |
299 |
$21K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
109 |
98 |
$17K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,092 |
1,013 |
$15K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
274 |
246 |
$14K |
| E1392 |
Portable oxygen concentrator, rental |
742 |
573 |
$13K |
| A7037 |
Tubing used with positive airway pressure device |
497 |
472 |
$12K |
| A7035 |
Headgear used with positive airway pressure device |
529 |
465 |
$10K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
447 |
368 |
$9K |
| 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) |
106 |
96 |
$9K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
455 |
335 |
$9K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
635 |
576 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,011 |
882 |
$5K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
45 |
39 |
$4K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
27 |
25 |
$4K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
178 |
159 |
$3K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
58 |
52 |
$968.85 |
| E0570 |
Nebulizer, with compressor |
33 |
31 |
$816.40 |
| K0001 |
Standard wheelchair |
31 |
27 |
$291.37 |