| 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 |
532 |
520 |
$17K |
| E0601 |
Continuous positive airway pressure (cpap) device |
126 |
118 |
$4K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
175 |
103 |
$3K |
| 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 |
145 |
81 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
415 |
406 |
$2K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
249 |
249 |
$49.52 |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
144 |
143 |
$24.02 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
165 |
165 |
$17.60 |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
202 |
202 |
$0.00 |
| A4623 |
Tracheostomy, inner cannula |
12 |
12 |
$0.00 |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
72 |
72 |
$0.00 |