| 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 |
9,512 |
8,475 |
$263K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
1,405 |
595 |
$104K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,162 |
1,381 |
$51K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,547 |
5,763 |
$46K |
| 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 |
1,406 |
928 |
$20K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
169 |
130 |
$19K |
| E0601 |
Continuous positive airway pressure (cpap) device |
182 |
128 |
$5K |
| E0570 |
Nebulizer, with compressor |
1,032 |
918 |
$4K |
| A7037 |
Tubing used with positive airway pressure device |
267 |
184 |
$3K |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
689 |
606 |
$3K |
| E1392 |
Portable oxygen concentrator, rental |
411 |
366 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
188 |
117 |
$2K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
82 |
75 |
$1K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
572 |
497 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
314 |
225 |
$987.81 |
| J7605 |
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms |
23 |
14 |
$900.89 |
| 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 |
76 |
60 |
$546.40 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
727 |
623 |
$228.12 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
52 |
39 |
$179.59 |
| K0001 |
Standard wheelchair |
28 |
26 |
$133.24 |
| A7031 |
Face mask interface, replacement for full face mask, each |
15 |
12 |
$74.22 |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
27 |
26 |
$47.50 |