| 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 |
12,904 |
11,393 |
$376K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
469 |
403 |
$94K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,181 |
1,886 |
$79K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,453 |
6,500 |
$76K |
| 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 |
1,850 |
1,577 |
$45K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,387 |
1,211 |
$42K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
945 |
817 |
$40K |
| E0570 |
Nebulizer, with compressor |
3,706 |
3,287 |
$11K |
| E1392 |
Portable oxygen concentrator, rental |
1,423 |
1,247 |
$11K |
| B9002 |
Enteral nutrition infusion pump, any type |
309 |
300 |
$6K |
| 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 |
37 |
36 |
$2K |
| E0601 |
Continuous positive airway pressure (cpap) device |
129 |
91 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,128 |
834 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,096 |
1,796 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
203 |
160 |
$1K |
| A7037 |
Tubing used with positive airway pressure device |
346 |
312 |
$1K |
| A7031 |
Face mask interface, replacement for full face mask, each |
70 |
63 |
$644.42 |
| E0776 |
Iv pole |
87 |
87 |
$296.95 |
| A7035 |
Headgear used with positive airway pressure device |
26 |
25 |
$142.88 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
40 |
36 |
$78.16 |