| 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 |
915 |
700 |
$517K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
749 |
717 |
$120K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,609 |
1,601 |
$87K |
| 99601 |
|
832 |
222 |
$82K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
962 |
923 |
$79K |
| 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 |
1,164 |
1,132 |
$54K |
| 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 |
459 |
450 |
$44K |
| 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 |
481 |
463 |
$41K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
200 |
200 |
$22K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
345 |
331 |
$22K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
485 |
483 |
$18K |
| A4554 |
Disposable underpads, all sizes |
329 |
317 |
$14K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
843 |
812 |
$14K |
| 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 |
84 |
80 |
$13K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
179 |
179 |
$9K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
189 |
186 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
702 |
700 |
$8K |
| A7037 |
Tubing used with positive airway pressure device |
711 |
708 |
$6K |
| E1399 |
Durable medical equipment, miscellaneous |
51 |
44 |
$5K |
| K0001 |
Standard wheelchair |
138 |
137 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
39 |
39 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
187 |
182 |
$2K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
24 |
24 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
689 |
687 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
193 |
193 |
$1K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
12 |
12 |
$867.73 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
205 |
205 |
$767.34 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
12 |
12 |
$238.60 |
| E0156 |
Seat attachment, walker |
13 |
13 |
$173.59 |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
13 |
13 |
$118.58 |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
16 |
15 |
$40.32 |