| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
138 |
124 |
$19K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
320 |
242 |
$15K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
179 |
133 |
$12K |
| E0601 |
Continuous positive airway pressure (cpap) device |
214 |
184 |
$9K |
| 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 |
29 |
24 |
$4K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
233 |
196 |
$4K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
193 |
160 |
$3K |
| E0570 |
Nebulizer, with compressor |
147 |
139 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
70 |
70 |
$878.88 |
| A7037 |
Tubing used with positive airway pressure device |
45 |
45 |
$700.72 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
12 |
12 |
$348.97 |
| K0001 |
Standard wheelchair |
17 |
13 |
$289.98 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
93 |
93 |
$265.92 |