| 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 |
6,596 |
5,275 |
$448K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
782 |
645 |
$256K |
| 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 |
1,922 |
1,262 |
$187K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
802 |
590 |
$106K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,726 |
1,503 |
$72K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,710 |
2,998 |
$61K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,419 |
902 |
$56K |
| B9002 |
Enteral nutrition infusion pump, any type |
920 |
842 |
$48K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
319 |
312 |
$22K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,348 |
2,045 |
$11K |
| E1392 |
Portable oxygen concentrator, rental |
1,892 |
1,480 |
$10K |
| K0001 |
Standard wheelchair |
545 |
453 |
$8K |
| E0570 |
Nebulizer, with compressor |
273 |
194 |
$4K |
| A7526 |
Tracheostomy tube collar/holder, each |
67 |
61 |
$2K |
| B9998 |
Noc for enteral supplies |
18 |
16 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
55 |
54 |
$1K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
75 |
61 |
$544.75 |
| A4629 |
Tracheostomy care kit for established tracheostomy |
15 |
13 |
$386.46 |
| E0776 |
Iv pole |
30 |
26 |
$170.49 |