| 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 |
20,132 |
20,094 |
$577K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,703 |
1,609 |
$283K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
862 |
861 |
$161K |
| 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 |
914 |
843 |
$106K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,214 |
1,133 |
$76K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,543 |
11,523 |
$67K |
| 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 |
367 |
345 |
$25K |
| E1392 |
Portable oxygen concentrator, rental |
2,884 |
2,873 |
$23K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,082 |
1,077 |
$21K |
| E0570 |
Nebulizer, with compressor |
4,015 |
4,005 |
$11K |
| A7030 |
Full face mask used with positive airway pressure device, each |
529 |
529 |
$11K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
986 |
986 |
$8K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,149 |
1,147 |
$8K |
| K0001 |
Standard wheelchair |
312 |
312 |
$6K |
| 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 |
12 |
12 |
$6K |
| A7031 |
Face mask interface, replacement for full face mask, each |
459 |
459 |
$5K |
| E0776 |
Iv pole |
398 |
396 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,882 |
1,874 |
$4K |
| A7035 |
Headgear used with positive airway pressure device |
493 |
493 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
855 |
855 |
$3K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
92 |
92 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,959 |
1,861 |
$824.75 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
206 |
206 |
$451.91 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
12 |
12 |
$115.99 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
58 |
58 |
$111.94 |