| 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 |
51,847 |
49,474 |
$1.75M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,962 |
2,656 |
$750K |
| A7030 |
Full face mask used with positive airway pressure device, each |
6,145 |
5,847 |
$287K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
31,644 |
30,169 |
$255K |
| A7031 |
Face mask interface, replacement for full face mask, each |
8,224 |
7,715 |
$193K |
| E0601 |
Continuous positive airway pressure (cpap) device |
7,747 |
7,309 |
$147K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
5,507 |
5,243 |
$116K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,523 |
3,373 |
$102K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,321 |
2,055 |
$82K |
| A7035 |
Headgear used with positive airway pressure device |
6,871 |
6,512 |
$77K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,895 |
2,734 |
$77K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
6,557 |
6,108 |
$53K |
| E0570 |
Nebulizer, with compressor |
8,410 |
7,942 |
$49K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
15,539 |
14,423 |
$42K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,563 |
1,472 |
$31K |
| 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) |
906 |
858 |
$30K |
| A7037 |
Tubing used with positive airway pressure device |
4,134 |
3,973 |
$26K |
| E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
541 |
530 |
$21K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,222 |
3,125 |
$21K |
| 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 |
504 |
457 |
$19K |
| 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 |
697 |
695 |
$17K |
| 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 |
465 |
434 |
$15K |
| E1392 |
Portable oxygen concentrator, rental |
1,567 |
1,506 |
$14K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
760 |
743 |
$10K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
867 |
829 |
$8K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,511 |
1,447 |
$6K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
632 |
610 |
$6K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
283 |
279 |
$4K |
| 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) |
26 |
24 |
$2K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
27 |
24 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,349 |
2,170 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
69 |
69 |
$1K |
| E0442 |
Stationary oxygen contents, liquid, 1 month's supply = 1 unit |
51 |
49 |
$818.01 |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
52 |
52 |
$420.17 |
| A7036 |
Chinstrap used with positive airway pressure device |
44 |
41 |
$362.83 |
| A7015 |
Aerosol mask, used with dme nebulizer |
286 |
278 |
$228.11 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
456 |
438 |
$201.81 |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
25 |
25 |
$129.86 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
14 |
13 |
$60.54 |