| 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 |
3,597 |
3,586 |
$162K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
257 |
199 |
$65K |
| B9998 |
Noc for enteral supplies |
392 |
295 |
$25K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,095 |
2,079 |
$20K |
| A4554 |
Disposable underpads, all sizes |
493 |
444 |
$15K |
| A7031 |
Face mask interface, replacement for full face mask, each |
301 |
297 |
$13K |
| A7037 |
Tubing used with positive airway pressure device |
561 |
553 |
$10K |
| E0570 |
Nebulizer, with compressor |
1,159 |
1,157 |
$5K |
| A4335 |
Incontinence supply; miscellaneous |
762 |
688 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
769 |
753 |
$3K |
| K0001 |
Standard wheelchair |
166 |
166 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
404 |
387 |
$403.24 |
| E1392 |
Portable oxygen concentrator, rental |
117 |
117 |
$310.24 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
12 |
12 |
$130.80 |