| 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 |
8,414 |
7,336 |
$246K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,254 |
2,847 |
$125K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,023 |
910 |
$35K |
| A7030 |
Full face mask used with positive airway pressure device, each |
984 |
865 |
$34K |
| E1392 |
Portable oxygen concentrator, rental |
2,004 |
1,707 |
$30K |
| 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 |
1,926 |
1,667 |
$25K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,929 |
4,360 |
$23K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,036 |
923 |
$20K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,624 |
2,378 |
$14K |
| A7037 |
Tubing used with positive airway pressure device |
1,710 |
1,557 |
$10K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,025 |
920 |
$8K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
285 |
257 |
$7K |
| A7035 |
Headgear used with positive airway pressure device |
891 |
795 |
$6K |
| E0570 |
Nebulizer, with compressor |
2,331 |
2,188 |
$6K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
488 |
426 |
$6K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
68 |
63 |
$3K |
| B9002 |
Enteral nutrition infusion pump, any type |
158 |
131 |
$3K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
338 |
316 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
56 |
52 |
$126.71 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
236 |
213 |
$114.56 |
| 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) |
12 |
12 |
$101.40 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
13 |
13 |
$1.14 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
64 |
58 |
$0.00 |