| 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 |
20,121 |
18,347 |
$1.92M |
| E0601 |
Continuous positive airway pressure (cpap) device |
35,072 |
32,850 |
$1.73M |
| A7030 |
Full face mask used with positive airway pressure device, each |
11,456 |
10,218 |
$984K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,971 |
2,542 |
$763K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
22,777 |
21,525 |
$671K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
9,620 |
8,496 |
$527K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
705 |
477 |
$427K |
| A7035 |
Headgear used with positive airway pressure device |
15,078 |
13,372 |
$311K |
| A7031 |
Face mask interface, replacement for full face mask, each |
9,679 |
8,473 |
$304K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
9,640 |
8,517 |
$266K |
| 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) |
2,820 |
2,426 |
$265K |
| 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 |
720 |
583 |
$259K |
| E0651 |
Pneumatic compressor, segmental home model without calibrated gradient pressure |
853 |
710 |
$237K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,676 |
7,950 |
$235K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
5,357 |
4,619 |
$206K |
| A7037 |
Tubing used with positive airway pressure device |
10,925 |
9,581 |
$202K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
13,244 |
11,498 |
$143K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
802 |
344 |
$133K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
23,788 |
21,090 |
$129K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
4,755 |
4,110 |
$124K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,600 |
1,391 |
$80K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,060 |
1,010 |
$70K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
392 |
327 |
$64K |
| E1392 |
Portable oxygen concentrator, rental |
2,841 |
2,640 |
$58K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
500 |
454 |
$54K |
| 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 |
113 |
103 |
$52K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
5,912 |
5,140 |
$42K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
565 |
489 |
$27K |
| E0570 |
Nebulizer, with compressor |
355 |
325 |
$24K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
995 |
465 |
$23K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,983 |
1,713 |
$22K |
| B9998 |
Noc for enteral supplies |
1,308 |
1,119 |
$21K |
| E0667 |
Segmental pneumatic appliance for use with pneumatic compressor, full leg |
74 |
29 |
$18K |
| A7002 |
Tubing, used with suction pump, each |
2,007 |
1,762 |
$10K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
280 |
261 |
$9K |
| A7036 |
Chinstrap used with positive airway pressure device |
768 |
708 |
$8K |
| A4605 |
Tracheal suction catheter, closed system, each |
48 |
40 |
$7K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
59 |
52 |
$7K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,550 |
1,387 |
$5K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
155 |
151 |
$4K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
75 |
75 |
$4K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
418 |
331 |
$3K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
13 |
12 |
$2K |
| B9002 |
Enteral nutrition infusion pump, any type |
15 |
12 |
$1K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
465 |
403 |
$1K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
13 |
12 |
$891.60 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
12 |
12 |
$546.57 |
| A4649 |
Surgical supply; miscellaneous |
26 |
24 |
$546.18 |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
15 |
12 |
$426.75 |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
12 |
12 |
$341.03 |
| A7015 |
Aerosol mask, used with dme nebulizer |
140 |
135 |
$240.56 |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
46 |
24 |
$185.46 |