Transtracheal oxygen catheter, each

Portable oxygen concentrator, rental

Tubing (oxygen), per foot

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate

Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each

Oxygen probe for use with oximeter device, replacement

Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval

Oxygen tent, excluding croup or pediatric tents

Ambulance (als or bls) oxygen and oxygen supplies, life sustaining situation

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing

Regulator

Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen

Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing

Stand/rack

Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge

Repair or nonroutine service for oxygen equipment requiring the skill of a technician, labor component, per 15 minutes

Stationary liquid oxygen system, purchase; includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing

Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor

Topical hyperbaric oxygen chamber, disposable

Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes

Oximeter device for measuring blood oxygen levels non-invasively

Oxygen contents, liquid, 1 unit equals 1 pound

Stationary oxygen contents, gaseous, 1 month's supply = 1 unit

Stationary oxygen contents, liquid, 1 month's supply = 1 unit

Portable oxygen contents, gaseous, 1 month's supply = 1 unit

Portable oxygen contents, liquid, 1 month's supply = 1 unit

Oxygen contents, gaseous, 1 unit equals 1 cubic foot

Injection, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg

Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery

Oxygen accessory, flow regulator capable of positive inspiratory pressure

Oxygen and water vapor enriching system with heated delivery

Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit

Oxygen accessory, battery charger for portable concentrator, any type, replacement only, each

Oxygen and water vapor enriching system without heated delivery

Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval

Topical oxygen delivery system, not otherwise specified, includes all supplies and accessories

Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery

Injection, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, 1 mg

Oxygen accessory, battery pack/cartridge for portable concentrator, any type, replacement only, each

Oxygen accessory, dc power adapter for portable concentrator, any type, replacement only, each

Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, first dose

Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, second dose

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing

Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing

Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each

Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, first dose

Intravenous infusion, tocilizumab, for hospitalized adults and pediatric patients (2 years of age and older) with covid-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, includes infusion and post administration monitoring, second dose

Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing

Injection, monoclonal antibody products with an indication for post-exposure prophylaxis or treatment of covid-19, for hospitalized adults and/or pediatric patients who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ecmo) only, not otherwise classified, 1 mg

Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing