| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,623 |
906 |
$907K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
985 |
820 |
$398K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,735 |
2,240 |
$145K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
430 |
359 |
$102K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
666 |
533 |
$96K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,027 |
844 |
$56K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
592 |
474 |
$27K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
536 |
368 |
$22K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,350 |
1,105 |
$22K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,522 |
1,258 |
$20K |
| 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 |
443 |
351 |
$11K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
209 |
115 |
$9K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
71 |
52 |
$8K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
530 |
425 |
$7K |
| A7002 |
Tubing, used with suction pump, each |
1,359 |
1,100 |
$6K |
| A4927 |
Gloves, non-sterile, per 100 |
476 |
397 |
$4K |
| A4605 |
Tracheal suction catheter, closed system, each |
73 |
52 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
489 |
408 |
$2K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
21 |
13 |
$1K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
94 |
76 |
$663.84 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
13 |
12 |
$294.66 |
| A7525 |
Tracheostomy mask, each |
98 |
79 |
$285.12 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
38 |
37 |
$182.40 |