| 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 |
10,102 |
8,035 |
$472K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,474 |
3,380 |
$113K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,406 |
1,989 |
$100K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
9,116 |
7,262 |
$87K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,040 |
2,477 |
$62K |
| A7037 |
Tubing used with positive airway pressure device |
5,238 |
3,923 |
$48K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,517 |
1,896 |
$24K |
| 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 |
557 |
529 |
$23K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
730 |
695 |
$19K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
928 |
795 |
$17K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
6,323 |
4,869 |
$16K |
| A7035 |
Headgear used with positive airway pressure device |
1,993 |
1,681 |
$15K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
602 |
482 |
$12K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
228 |
222 |
$11K |
| 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 |
74 |
74 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,688 |
1,418 |
$4K |
| E0570 |
Nebulizer, with compressor |
1,542 |
1,489 |
$3K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
129 |
93 |
$2K |
| 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) |
13 |
13 |
$221.71 |
| A7000 |
Canister, disposable, used with suction pump, each |
16 |
12 |
$90.99 |