| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9342 |
Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
44 |
30 |
$10K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
91 |
91 |
$8K |
| 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 |
21 |
16 |
$6K |
| E0601 |
Continuous positive airway pressure (cpap) device |
77 |
77 |
$4K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
68 |
68 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
31 |
31 |
$735.90 |
| A7037 |
Tubing used with positive airway pressure device |
31 |
31 |
$708.89 |
| A7035 |
Headgear used with positive airway pressure device |
28 |
28 |
$700.72 |
| 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 |
12 |
12 |
$487.39 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
51 |
49 |
$270.17 |