| 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 |
19,793 |
19,664 |
$1.11M |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,689 |
3,673 |
$179K |
| A7031 |
Face mask interface, replacement for full face mask, each |
6,316 |
6,273 |
$179K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,071 |
11,025 |
$126K |
| E0570 |
Nebulizer, with compressor |
5,175 |
5,168 |
$100K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,272 |
2,259 |
$76K |
| E1392 |
Portable oxygen concentrator, rental |
3,038 |
3,019 |
$64K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,244 |
2,239 |
$64K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,293 |
2,282 |
$62K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
480 |
468 |
$52K |
| 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) |
840 |
838 |
$42K |
| A7037 |
Tubing used with positive airway pressure device |
5,520 |
5,496 |
$39K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,339 |
1,331 |
$33K |
| A7035 |
Headgear used with positive airway pressure device |
3,438 |
3,420 |
$31K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
10,717 |
10,635 |
$24K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
1,242 |
1,238 |
$21K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,772 |
2,764 |
$20K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,642 |
2,630 |
$12K |
| 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 |
104 |
102 |
$11K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
327 |
326 |
$6K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,255 |
1,252 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
294 |
294 |
$2K |
| K0001 |
Standard wheelchair |
62 |
62 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
30 |
30 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
475 |
466 |
$660.93 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
12 |
12 |
$54.26 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
96 |
95 |
$15.93 |