| 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 |
27,588 |
25,622 |
$1.97M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,562 |
1,502 |
$484K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,830 |
1,671 |
$369K |
| E0601 |
Continuous positive airway pressure (cpap) device |
6,413 |
6,155 |
$276K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
18,593 |
17,393 |
$255K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,733 |
3,612 |
$245K |
| 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 |
440 |
411 |
$122K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
7,241 |
6,823 |
$121K |
| 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 |
962 |
886 |
$118K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,438 |
3,347 |
$113K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
878 |
820 |
$70K |
| A7037 |
Tubing used with positive airway pressure device |
4,142 |
4,023 |
$55K |
| A7035 |
Headgear used with positive airway pressure device |
3,374 |
3,271 |
$52K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,136 |
1,092 |
$50K |
| 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) |
507 |
496 |
$48K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
9,564 |
9,189 |
$47K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,013 |
973 |
$44K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,031 |
950 |
$35K |
| 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 |
272 |
248 |
$35K |
| K0001 |
Standard wheelchair |
1,232 |
1,145 |
$27K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,219 |
3,098 |
$25K |
| E0570 |
Nebulizer, with compressor |
2,603 |
2,568 |
$22K |
| B9998 |
Noc for enteral supplies |
406 |
383 |
$21K |
| E1392 |
Portable oxygen concentrator, rental |
1,600 |
1,558 |
$19K |
| B9002 |
Enteral nutrition infusion pump, any type |
249 |
247 |
$13K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
485 |
468 |
$12K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
307 |
294 |
$10K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
457 |
449 |
$9K |
| E0776 |
Iv pole |
714 |
667 |
$5K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
53 |
52 |
$4K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
415 |
407 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,266 |
2,130 |
$3K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
135 |
98 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
161 |
153 |
$1K |
| A7000 |
Canister, disposable, used with suction pump, each |
13 |
12 |
$130.57 |