| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,876 |
1,533 |
$144K |
| 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 |
489 |
443 |
$72K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,163 |
2,844 |
$59K |
| 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 |
495 |
430 |
$33K |
| 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 |
293 |
254 |
$23K |
| B9002 |
Enteral nutrition infusion pump, any type |
306 |
251 |
$9K |
| E0776 |
Iv pole |
688 |
596 |
$5K |
| 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 |
13 |
$4K |
| E1392 |
Portable oxygen concentrator, rental |
1,071 |
1,011 |
$4K |
| E0570 |
Nebulizer, with compressor |
1,428 |
1,402 |
$3K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
737 |
663 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
631 |
588 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
117 |
111 |
$1K |
| A7030 |
Full face mask used with positive airway pressure device, each |
57 |
55 |
$1K |
| E0601 |
Continuous positive airway pressure (cpap) device |
125 |
116 |
$719.85 |
| A7031 |
Face mask interface, replacement for full face mask, each |
59 |
56 |
$495.64 |
| A7035 |
Headgear used with positive airway pressure device |
99 |
93 |
$369.88 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
134 |
126 |
$87.04 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
18 |
16 |
$85.84 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
30 |
25 |
$52.71 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
18 |
15 |
$26.41 |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
13 |
13 |
$0.00 |