| 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 |
8,258 |
4,941 |
$1.07M |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,265 |
847 |
$941K |
| 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 |
1,668 |
1,479 |
$679K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
859 |
846 |
$591K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,639 |
5,500 |
$392K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,728 |
1,690 |
$309K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
3,597 |
3,272 |
$251K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,510 |
6,339 |
$232K |
| B9002 |
Enteral nutrition infusion pump, any type |
2,737 |
2,671 |
$220K |
| 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 |
1,481 |
1,393 |
$213K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,544 |
1,479 |
$180K |
| 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 |
446 |
404 |
$174K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,607 |
1,467 |
$159K |
| E1399 |
Durable medical equipment, miscellaneous |
2,836 |
1,767 |
$157K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
347 |
340 |
$131K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,608 |
1,537 |
$99K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,636 |
1,606 |
$62K |
| B9998 |
Noc for enteral supplies |
1,691 |
1,131 |
$60K |
| A7526 |
Tracheostomy tube collar/holder, each |
2,477 |
2,246 |
$42K |
| E0619 |
Apnea monitor, with recording feature |
233 |
227 |
$41K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
414 |
407 |
$37K |
| A4605 |
Tracheal suction catheter, closed system, each |
625 |
562 |
$28K |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
157 |
144 |
$26K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
469 |
234 |
$25K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
1,533 |
1,415 |
$25K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
1,893 |
1,756 |
$21K |
| A7000 |
Canister, disposable, used with suction pump, each |
3,277 |
3,134 |
$19K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
3,438 |
3,196 |
$15K |
| A7002 |
Tubing, used with suction pump, each |
3,477 |
3,265 |
$10K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,045 |
1,002 |
$9K |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
3,640 |
3,420 |
$9K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,686 |
1,534 |
$8K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,651 |
1,510 |
$8K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
417 |
384 |
$7K |
| E0776 |
Iv pole |
40 |
40 |
$4K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
180 |
173 |
$3K |
| A4332 |
Lubricant, individual sterile packet, each |
1,872 |
1,724 |
$2K |
| E0601 |
Continuous positive airway pressure (cpap) device |
37 |
37 |
$1K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
883 |
800 |
$1K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
14 |
13 |
$624.83 |
| A7525 |
Tracheostomy mask, each |
244 |
217 |
$328.26 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
210 |
202 |
$251.35 |
| A7037 |
Tubing used with positive airway pressure device |
17 |
15 |
$242.92 |
| A4218 |
Sterile saline or water, metered dose dispenser, 10 ml |
26 |
25 |
$202.74 |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
37 |
36 |
$86.79 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
122 |
111 |
$33.25 |
| A4649 |
Surgical supply; miscellaneous |
31 |
30 |
$19.87 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
14 |
13 |
$11.61 |