| 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 |
41,464 |
34,392 |
$1.38M |
| 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 |
19,738 |
16,823 |
$563K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,990 |
2,719 |
$495K |
| 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 |
679 |
654 |
$399K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,362 |
1,115 |
$367K |
| E0601 |
Continuous positive airway pressure (cpap) device |
17,957 |
15,387 |
$357K |
| A7030 |
Full face mask used with positive airway pressure device, each |
7,011 |
5,982 |
$286K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,181 |
7,152 |
$268K |
| 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 |
1,440 |
1,347 |
$256K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
11,762 |
9,830 |
$218K |
| A7031 |
Face mask interface, replacement for full face mask, each |
7,938 |
6,791 |
$194K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
7,121 |
5,986 |
$174K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
11,309 |
9,549 |
$142K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
5,030 |
4,332 |
$107K |
| 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) |
2,498 |
2,035 |
$101K |
| B9002 |
Enteral nutrition infusion pump, any type |
946 |
882 |
$92K |
| A7035 |
Headgear used with positive airway pressure device |
9,230 |
7,919 |
$88K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
21,837 |
19,281 |
$80K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
4,456 |
3,911 |
$74K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,918 |
3,266 |
$66K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
673 |
555 |
$65K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
7,237 |
6,248 |
$39K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
114 |
109 |
$37K |
| 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 |
398 |
337 |
$35K |
| E0570 |
Nebulizer, with compressor |
8,576 |
7,051 |
$35K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,397 |
1,151 |
$33K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,990 |
1,660 |
$33K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
425 |
409 |
$32K |
| A7037 |
Tubing used with positive airway pressure device |
2,145 |
1,897 |
$29K |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
86 |
85 |
$24K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
462 |
450 |
$24K |
| K0001 |
Standard wheelchair |
3,976 |
3,040 |
$24K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
70 |
36 |
$21K |
| E1392 |
Portable oxygen concentrator, rental |
2,806 |
2,268 |
$17K |
| B9998 |
Noc for enteral supplies |
418 |
357 |
$16K |
| E0776 |
Iv pole |
947 |
928 |
$15K |
| K0003 |
Lightweight wheelchair |
2,296 |
1,758 |
$14K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
410 |
404 |
$12K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
2,030 |
1,751 |
$8K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
98 |
91 |
$7K |
| 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 |
46 |
40 |
$5K |
| A7036 |
Chinstrap used with positive airway pressure device |
995 |
826 |
$5K |
| A7526 |
Tracheostomy tube collar/holder, each |
168 |
128 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,593 |
1,235 |
$5K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,143 |
659 |
$3K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,001 |
797 |
$3K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
147 |
78 |
$3K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
32 |
25 |
$3K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
15 |
12 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,241 |
1,058 |
$2K |
| A7002 |
Tubing, used with suction pump, each |
1,030 |
577 |
$1K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
80 |
74 |
$1K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
236 |
209 |
$1K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
55 |
51 |
$786.24 |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
68 |
48 |
$729.01 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,169 |
908 |
$670.49 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
44 |
39 |
$599.79 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
184 |
145 |
$333.38 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
821 |
684 |
$212.84 |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
35 |
24 |
$141.94 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
87 |
79 |
$28.02 |
| A7015 |
Aerosol mask, used with dme nebulizer |
16 |
14 |
$4.02 |