| 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 |
2,895 |
2,476 |
$199K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
740 |
630 |
$199K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
781 |
621 |
$82K |
| B9002 |
Enteral nutrition infusion pump, any type |
552 |
513 |
$28K |
| 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 |
239 |
141 |
$18K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
552 |
331 |
$17K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
780 |
658 |
$14K |
| E0601 |
Continuous positive airway pressure (cpap) device |
177 |
137 |
$7K |
| E1392 |
Portable oxygen concentrator, rental |
693 |
624 |
$5K |
| 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 |
14 |
12 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
476 |
446 |
$2K |
| K0001 |
Standard wheelchair |
148 |
101 |
$1K |
| B9998 |
Noc for enteral supplies |
15 |
14 |
$891.16 |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
12 |
12 |
$855.00 |