| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
2,590 |
2,018 |
$1.41M |
| 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 |
7,638 |
6,509 |
$1.19M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
9,222 |
7,098 |
$849K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
27,924 |
21,669 |
$722K |
| 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 |
4,546 |
3,376 |
$279K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
995 |
824 |
$253K |
| 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 |
3,442 |
2,679 |
$237K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
665 |
529 |
$210K |
| B9002 |
Enteral nutrition infusion pump, any type |
2,178 |
1,818 |
$188K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,443 |
2,695 |
$130K |
| B9998 |
Noc for enteral supplies |
4,729 |
3,198 |
$127K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
5,081 |
4,504 |
$125K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
17,968 |
14,086 |
$112K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,377 |
2,069 |
$107K |
| B4103 |
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
695 |
595 |
$88K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,276 |
1,687 |
$81K |
| 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 |
516 |
396 |
$67K |
| E0570 |
Nebulizer, with compressor |
5,140 |
3,974 |
$63K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,037 |
2,615 |
$61K |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
369 |
322 |
$56K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,733 |
1,479 |
$49K |
| E0776 |
Iv pole |
2,476 |
2,111 |
$42K |
| E1392 |
Portable oxygen concentrator, rental |
3,708 |
2,923 |
$40K |
| 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 |
1,010 |
870 |
$38K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,987 |
3,103 |
$35K |
| A7035 |
Headgear used with positive airway pressure device |
2,993 |
2,586 |
$33K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,281 |
1,070 |
$26K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,005 |
854 |
$22K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,502 |
2,193 |
$18K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
9,005 |
7,087 |
$16K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
112 |
85 |
$7K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
343 |
309 |
$6K |
| A7037 |
Tubing used with positive airway pressure device |
805 |
682 |
$5K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
528 |
370 |
$4K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
597 |
492 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,548 |
1,953 |
$2K |
| 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) |
31 |
26 |
$918.63 |
| A7000 |
Canister, disposable, used with suction pump, each |
58 |
50 |
$732.48 |
| A7015 |
Aerosol mask, used with dme nebulizer |
579 |
513 |
$425.37 |
| A7002 |
Tubing, used with suction pump, each |
82 |
64 |
$347.71 |
| G0249 |
Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests |
516 |
437 |
$213.76 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
42 |
37 |
$171.19 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
109 |
105 |
$54.67 |