| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
5,514 |
5,323 |
$2.49M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
32,229 |
31,237 |
$1.92M |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
734 |
593 |
$470K |
| E0601 |
Continuous positive airway pressure (cpap) device |
9,296 |
8,888 |
$326K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,738 |
1,848 |
$283K |
| 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 |
704 |
599 |
$256K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
15,621 |
15,060 |
$195K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,032 |
1,941 |
$123K |
| 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 |
8,225 |
8,025 |
$117K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,548 |
2,475 |
$100K |
| 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 |
590 |
505 |
$92K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,058 |
1,014 |
$91K |
| 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) |
938 |
909 |
$67K |
| 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 |
490 |
426 |
$64K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,165 |
2,101 |
$58K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
523 |
498 |
$52K |
| A7035 |
Headgear used with positive airway pressure device |
3,254 |
3,133 |
$45K |
| B9998 |
Noc for enteral supplies |
641 |
445 |
$42K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,798 |
1,709 |
$39K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,466 |
1,425 |
$36K |
| E0570 |
Nebulizer, with compressor |
1,349 |
1,320 |
$33K |
| A7037 |
Tubing used with positive airway pressure device |
2,423 |
2,334 |
$33K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,939 |
4,779 |
$27K |
| B9002 |
Enteral nutrition infusion pump, any type |
535 |
534 |
$27K |
| E1392 |
Portable oxygen concentrator, rental |
1,327 |
1,304 |
$21K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,852 |
1,796 |
$15K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
487 |
464 |
$11K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
207 |
184 |
$9K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
118 |
90 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
355 |
327 |
$4K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
128 |
128 |
$4K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
507 |
489 |
$3K |
| A7036 |
Chinstrap used with positive airway pressure device |
267 |
258 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
101 |
100 |
$119.65 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
240 |
235 |
$111.42 |