| 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 |
10,893 |
10,820 |
$552K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
768 |
696 |
$138K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
351 |
347 |
$104K |
| 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 |
489 |
440 |
$80K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,141 |
6,066 |
$68K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,871 |
1,844 |
$61K |
| B9998 |
Noc for enteral supplies |
552 |
508 |
$50K |
| 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 |
284 |
254 |
$39K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,215 |
1,201 |
$39K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,358 |
1,340 |
$29K |
| 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 |
61 |
52 |
$26K |
| B9002 |
Enteral nutrition infusion pump, any type |
394 |
390 |
$21K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,515 |
2,491 |
$18K |
| E0570 |
Nebulizer, with compressor |
2,834 |
2,817 |
$13K |
| A7035 |
Headgear used with positive airway pressure device |
1,177 |
1,163 |
$10K |
| A7037 |
Tubing used with positive airway pressure device |
1,274 |
1,258 |
$10K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,717 |
2,679 |
$9K |
| 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) |
127 |
124 |
$7K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
236 |
231 |
$5K |
| E1392 |
Portable oxygen concentrator, rental |
513 |
502 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,006 |
999 |
$3K |
| E0776 |
Iv pole |
276 |
275 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
80 |
80 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,678 |
1,575 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
142 |
138 |
$1K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
12 |
12 |
$903.85 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
46 |
40 |
$356.71 |
| J7626 |
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg |
13 |
12 |
$310.56 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
38 |
38 |
$292.15 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
16 |
13 |
$41.20 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
13 |
12 |
$27.08 |