| 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 |
26,780 |
23,553 |
$611K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,829 |
1,767 |
$158K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
12,954 |
11,384 |
$69K |
| 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 |
1,172 |
800 |
$50K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,400 |
973 |
$45K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,312 |
2,194 |
$39K |
| 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 |
825 |
597 |
$34K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,288 |
1,209 |
$32K |
| 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 |
186 |
180 |
$16K |
| E0601 |
Continuous positive airway pressure (cpap) device |
943 |
867 |
$14K |
| E1392 |
Portable oxygen concentrator, rental |
2,250 |
1,956 |
$13K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
77 |
62 |
$10K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,523 |
4,242 |
$8K |
| A7037 |
Tubing used with positive airway pressure device |
1,956 |
1,834 |
$8K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
756 |
700 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
1,302 |
1,225 |
$8K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
407 |
380 |
$6K |
| E0570 |
Nebulizer, with compressor |
3,119 |
2,789 |
$6K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
979 |
877 |
$5K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
311 |
295 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
988 |
937 |
$4K |
| B9002 |
Enteral nutrition infusion pump, any type |
84 |
78 |
$2K |
| K0001 |
Standard wheelchair |
274 |
246 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,063 |
1,853 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
45 |
42 |
$317.72 |
| E0776 |
Iv pole |
55 |
50 |
$279.73 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
121 |
113 |
$231.60 |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
15 |
12 |
$202.19 |
| B9998 |
Noc for enteral supplies |
15 |
13 |
$177.41 |