| 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 |
27,729 |
27,530 |
$1.91M |
| 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 |
1,050 |
1,013 |
$561K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
958 |
950 |
$423K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
15,588 |
15,474 |
$190K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,084 |
2,049 |
$65K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,555 |
1,547 |
$61K |
| E1392 |
Portable oxygen concentrator, rental |
2,454 |
2,440 |
$60K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
398 |
383 |
$46K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,728 |
1,712 |
$44K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,334 |
1,314 |
$35K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,634 |
1,623 |
$30K |
| 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 |
128 |
115 |
$26K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
970 |
969 |
$26K |
| E0570 |
Nebulizer, with compressor |
2,499 |
2,494 |
$23K |
| K0001 |
Standard wheelchair |
925 |
917 |
$19K |
| A7037 |
Tubing used with positive airway pressure device |
3,007 |
2,983 |
$19K |
| A7035 |
Headgear used with positive airway pressure device |
2,133 |
2,119 |
$19K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
263 |
263 |
$16K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,071 |
2,050 |
$15K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,222 |
5,142 |
$13K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
218 |
218 |
$4K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
37 |
37 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,267 |
1,260 |
$3K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
28 |
27 |
$1K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
51 |
51 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
557 |
534 |
$860.17 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
64 |
62 |
$833.07 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
12 |
12 |
$591.40 |
| A7000 |
Canister, disposable, used with suction pump, each |
58 |
56 |
$347.36 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
12 |
12 |
$133.93 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
61 |
61 |
$121.18 |
| A7002 |
Tubing, used with suction pump, each |
44 |
43 |
$94.46 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
27 |
26 |
$69.40 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
27 |
25 |
$42.79 |