| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
5,041 |
3,064 |
$407K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
23,239 |
14,619 |
$341K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,375 |
2,414 |
$296K |
| 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 |
913 |
868 |
$216K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,164 |
2,134 |
$117K |
| 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 |
1,302 |
897 |
$91K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,819 |
4,487 |
$47K |
| 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 |
1,478 |
984 |
$44K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,062 |
2,704 |
$40K |
| E1392 |
Portable oxygen concentrator, rental |
11,941 |
7,272 |
$23K |
| B9998 |
Noc for enteral supplies |
698 |
611 |
$20K |
| E0570 |
Nebulizer, with compressor |
10,483 |
6,522 |
$12K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,372 |
845 |
$10K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,280 |
1,014 |
$7K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,317 |
1,365 |
$7K |
| 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 |
22 |
12 |
$6K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
6,338 |
3,843 |
$4K |
| B9002 |
Enteral nutrition infusion pump, any type |
96 |
86 |
$4K |
| 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 |
59 |
49 |
$3K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
492 |
259 |
$3K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,502 |
843 |
$3K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
565 |
291 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
2,850 |
1,837 |
$2K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
54 |
50 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
2,417 |
1,520 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
390 |
217 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
673 |
409 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,788 |
1,114 |
$925.38 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,000 |
2,837 |
$644.24 |
| E0776 |
Iv pole |
84 |
83 |
$534.57 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
18 |
14 |
$257.93 |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,322 |
1,437 |
$213.81 |
| A7002 |
Tubing, used with suction pump, each |
61 |
52 |
$54.80 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
21 |
12 |
$0.52 |