| 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 |
11,340 |
8,793 |
$288K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,997 |
2,187 |
$75K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,269 |
2,068 |
$59K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,359 |
6,761 |
$53K |
| A7030 |
Full face mask used with positive airway pressure device, each |
882 |
810 |
$47K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,332 |
1,179 |
$26K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,500 |
2,556 |
$26K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
912 |
829 |
$25K |
| A7035 |
Headgear used with positive airway pressure device |
1,617 |
1,461 |
$18K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,496 |
3,959 |
$8K |
| E0570 |
Nebulizer, with compressor |
1,004 |
778 |
$7K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
402 |
368 |
$7K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,021 |
912 |
$7K |
| K0001 |
Standard wheelchair |
167 |
134 |
$2K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
190 |
149 |
$1K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
69 |
64 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
246 |
218 |
$1K |
| 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 |
25 |
25 |
$412.82 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
39 |
38 |
$274.63 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
37 |
27 |
$26.42 |