| 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 |
39,089 |
36,753 |
$2.14M |
| E0441 |
Stationary oxygen contents, gaseous, 1 month's supply = 1 unit |
6,511 |
6,084 |
$300K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
20,790 |
19,672 |
$248K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
451 |
428 |
$228K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,814 |
3,315 |
$156K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,196 |
1,865 |
$138K |
| E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
2,078 |
1,999 |
$136K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,317 |
2,058 |
$125K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,567 |
2,200 |
$118K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,870 |
2,542 |
$75K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,929 |
1,721 |
$59K |
| E0442 |
Stationary oxygen contents, liquid, 1 month's supply = 1 unit |
2,183 |
1,743 |
$56K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
2,112 |
1,916 |
$50K |
| 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 |
964 |
827 |
$43K |
| E1392 |
Portable oxygen concentrator, rental |
3,066 |
2,924 |
$41K |
| A7037 |
Tubing used with positive airway pressure device |
2,793 |
2,607 |
$32K |
| 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 |
1,098 |
926 |
$32K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
44 |
25 |
$32K |
| A7035 |
Headgear used with positive airway pressure device |
2,689 |
2,412 |
$32K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,544 |
1,370 |
$31K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
132 |
108 |
$28K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,572 |
2,227 |
$23K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,099 |
966 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
6,301 |
5,666 |
$17K |
| E0570 |
Nebulizer, with compressor |
1,450 |
1,282 |
$11K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
473 |
410 |
$9K |
| E0444 |
Portable oxygen contents, liquid, 1 month's supply = 1 unit |
717 |
592 |
$7K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
61 |
37 |
$6K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
170 |
127 |
$5K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
248 |
231 |
$5K |
| 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 |
14 |
12 |
$4K |
| E0776 |
Iv pole |
646 |
634 |
$2K |
| B9002 |
Enteral nutrition infusion pump, any type |
116 |
113 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
201 |
160 |
$298.17 |
| A7000 |
Canister, disposable, used with suction pump, each |
47 |
25 |
$33.23 |