| 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 |
10,573 |
8,694 |
$395K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
254 |
215 |
$66K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,746 |
4,727 |
$54K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,219 |
1,092 |
$50K |
| A7030 |
Full face mask used with positive airway pressure device, each |
246 |
228 |
$21K |
| E0570 |
Nebulizer, with compressor |
1,018 |
812 |
$21K |
| A7031 |
Face mask interface, replacement for full face mask, each |
429 |
390 |
$14K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,075 |
949 |
$14K |
| K0001 |
Standard wheelchair |
1,082 |
876 |
$14K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 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 |
49 |
27 |
$12K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
306 |
277 |
$10K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
282 |
237 |
$9K |
| A7035 |
Headgear used with positive airway pressure device |
321 |
290 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
775 |
686 |
$3K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
49 |
45 |
$3K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
104 |
89 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
119 |
94 |
$615.76 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
105 |
89 |
$549.71 |
| A7037 |
Tubing used with positive airway pressure device |
39 |
37 |
$454.57 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
13 |
13 |
$75.21 |