| 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 |
47,594 |
30,377 |
$1.71M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,949 |
1,608 |
$635K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,566 |
1,404 |
$358K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
549 |
328 |
$303K |
| 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 |
3,384 |
2,714 |
$268K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
2,205 |
1,549 |
$261K |
| 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 |
590 |
523 |
$257K |
| 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 |
1,773 |
1,548 |
$242K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
24,398 |
15,692 |
$158K |
| A7030 |
Full face mask used with positive airway pressure device, each |
4,367 |
2,792 |
$156K |
| E0601 |
Continuous positive airway pressure (cpap) device |
6,656 |
4,122 |
$139K |
| A7031 |
Face mask interface, replacement for full face mask, each |
5,653 |
3,556 |
$104K |
| E1392 |
Portable oxygen concentrator, rental |
5,411 |
3,391 |
$49K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
7,432 |
4,645 |
$47K |
| A4217 |
Sterile water/saline, 500 ml |
561 |
419 |
$34K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,632 |
1,054 |
$34K |
| A7037 |
Tubing used with positive airway pressure device |
3,480 |
2,242 |
$32K |
| A7035 |
Headgear used with positive airway pressure device |
3,772 |
2,510 |
$31K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
10,019 |
6,822 |
$27K |
| E0570 |
Nebulizer, with compressor |
5,708 |
3,997 |
$24K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
677 |
428 |
$17K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,322 |
1,627 |
$16K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
80 |
52 |
$12K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
137 |
40 |
$5K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
19 |
15 |
$5K |
| 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) |
119 |
74 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,083 |
725 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,963 |
1,303 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,825 |
2,655 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
74 |
63 |
$2K |
| A7526 |
Tracheostomy tube collar/holder, each |
51 |
39 |
$1K |
| A7000 |
Canister, disposable, used with suction pump, each |
132 |
98 |
$1K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
70 |
42 |
$516.84 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
120 |
80 |
$464.69 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
417 |
333 |
$394.09 |
| A7002 |
Tubing, used with suction pump, each |
77 |
55 |
$300.33 |
| A7525 |
Tracheostomy mask, each |
57 |
12 |
$68.34 |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
27 |
13 |
$56.45 |
| A7015 |
Aerosol mask, used with dme nebulizer |
102 |
66 |
$56.41 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
92 |
68 |
$26.36 |