| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,469 |
1,937 |
$724K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
15,197 |
11,597 |
$317K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
940 |
795 |
$124K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
10,064 |
7,720 |
$118K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,600 |
3,062 |
$68K |
| 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 |
180 |
170 |
$46K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,067 |
2,761 |
$41K |
| B9998 |
Noc for enteral supplies |
423 |
399 |
$23K |
| 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 |
24 |
24 |
$20K |
| 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) |
316 |
266 |
$20K |
| E0570 |
Nebulizer, with compressor |
5,127 |
3,906 |
$20K |
| B9002 |
Enteral nutrition infusion pump, any type |
268 |
259 |
$16K |
| 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 |
239 |
196 |
$12K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,131 |
907 |
$7K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,051 |
828 |
$7K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
111 |
82 |
$7K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,522 |
1,158 |
$6K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
14 |
12 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,328 |
1,645 |
$2K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
66 |
63 |
$2K |
| E1392 |
Portable oxygen concentrator, rental |
525 |
410 |
$2K |
| E0776 |
Iv pole |
174 |
171 |
$2K |
| 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 |
31 |
25 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,157 |
883 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
1,457 |
1,116 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,357 |
2,591 |
$971.28 |
| K0001 |
Standard wheelchair |
170 |
154 |
$799.97 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,020 |
792 |
$620.69 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
178 |
133 |
$477.52 |
| A7037 |
Tubing used with positive airway pressure device |
763 |
589 |
$447.20 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
30 |
24 |
$415.17 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
169 |
143 |
$390.76 |
| A7000 |
Canister, disposable, used with suction pump, each |
33 |
25 |
$177.38 |
| A7002 |
Tubing, used with suction pump, each |
74 |
55 |
$87.69 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
16 |
12 |
$0.00 |