| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,458 |
1,342 |
$492K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
18,024 |
14,927 |
$441K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,354 |
3,165 |
$109K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
9,138 |
7,072 |
$104K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,080 |
930 |
$104K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,688 |
3,497 |
$62K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,681 |
3,234 |
$55K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,089 |
2,006 |
$37K |
| E1392 |
Portable oxygen concentrator, rental |
3,337 |
2,869 |
$34K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,854 |
3,216 |
$26K |
| A7035 |
Headgear used with positive airway pressure device |
3,410 |
3,234 |
$25K |
| A7037 |
Tubing used with positive airway pressure device |
5,239 |
4,834 |
$23K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,139 |
1,095 |
$19K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,019 |
6,610 |
$16K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,607 |
3,404 |
$14K |
| E0570 |
Nebulizer, with compressor |
6,974 |
6,413 |
$12K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
633 |
599 |
$9K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,841 |
3,422 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
684 |
642 |
$1K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
297 |
258 |
$602.80 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
131 |
130 |
$400.84 |
| A7526 |
Tracheostomy tube collar/holder, each |
18 |
13 |
$298.73 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
12 |
12 |
$224.03 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
24 |
24 |
$149.75 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
12 |
12 |
$149.31 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
27 |
25 |
$128.72 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
485 |
454 |
$56.19 |
| E0776 |
Iv pole |
14 |
12 |
$52.60 |
| 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 |
12 |
$16.40 |
| A7525 |
Tracheostomy mask, each |
14 |
12 |
$1.84 |