| 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 |
35,703 |
30,592 |
$1.69M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,403 |
1,265 |
$471K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,028 |
1,650 |
$274K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
23,459 |
20,026 |
$194K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,460 |
2,181 |
$123K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,005 |
3,688 |
$103K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,514 |
2,245 |
$88K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
756 |
596 |
$78K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,229 |
2,529 |
$58K |
| E0570 |
Nebulizer, with compressor |
11,281 |
9,830 |
$55K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,939 |
2,554 |
$53K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
793 |
610 |
$53K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,551 |
1,350 |
$43K |
| E1392 |
Portable oxygen concentrator, rental |
3,484 |
3,022 |
$43K |
| K0001 |
Standard wheelchair |
4,652 |
3,771 |
$41K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,371 |
2,970 |
$36K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,349 |
1,197 |
$35K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,091 |
6,457 |
$25K |
| A7035 |
Headgear used with positive airway pressure device |
2,411 |
2,124 |
$25K |
| 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) |
310 |
261 |
$23K |
| A7037 |
Tubing used with positive airway pressure device |
1,096 |
976 |
$11K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
699 |
631 |
$11K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,858 |
1,637 |
$9K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
1,560 |
1,041 |
$7K |
| B9002 |
Enteral nutrition infusion pump, any type |
132 |
105 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,857 |
2,283 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
298 |
238 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
113 |
92 |
$3K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
162 |
154 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
387 |
315 |
$2K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
18 |
12 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
184 |
140 |
$522.47 |
| E0156 |
Seat attachment, walker |
140 |
112 |
$384.16 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
34 |
27 |
$133.85 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
33 |
24 |
$45.05 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
88 |
81 |
$25.16 |
| A7015 |
Aerosol mask, used with dme nebulizer |
29 |
27 |
$16.21 |