| 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 |
4,020 |
3,466 |
$1.16M |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,889 |
1,596 |
$1.00M |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,022 |
787 |
$861K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
2,354 |
1,955 |
$735K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
3,626 |
2,964 |
$579K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,695 |
4,202 |
$509K |
| E0601 |
Continuous positive airway pressure (cpap) device |
7,859 |
7,242 |
$493K |
| 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) |
1,271 |
1,126 |
$486K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,058 |
864 |
$418K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,705 |
3,355 |
$296K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
5,985 |
5,679 |
$251K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,475 |
1,305 |
$241K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,836 |
4,383 |
$198K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
2,992 |
2,238 |
$171K |
| 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 |
1,073 |
942 |
$157K |
| E0570 |
Nebulizer, with compressor |
1,134 |
1,060 |
$138K |
| A7526 |
Tracheostomy tube collar/holder, each |
2,872 |
1,920 |
$127K |
| A4605 |
Tracheal suction catheter, closed system, each |
1,041 |
790 |
$126K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,552 |
4,328 |
$119K |
| A7035 |
Headgear used with positive airway pressure device |
4,169 |
3,826 |
$111K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,049 |
981 |
$109K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,342 |
848 |
$81K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,219 |
947 |
$66K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
2,228 |
1,853 |
$65K |
| A7000 |
Canister, disposable, used with suction pump, each |
3,675 |
2,945 |
$53K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
471 |
358 |
$43K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,193 |
2,872 |
$43K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
2,158 |
809 |
$43K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,474 |
1,245 |
$42K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,717 |
5,139 |
$36K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,267 |
1,160 |
$28K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,510 |
1,850 |
$28K |
| A7030 |
Full face mask used with positive airway pressure device, each |
192 |
182 |
$27K |
| A4927 |
Gloves, non-sterile, per 100 |
2,160 |
1,510 |
$19K |
| A7002 |
Tubing, used with suction pump, each |
3,839 |
3,033 |
$17K |
| E0776 |
Iv pole |
702 |
657 |
$7K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
157 |
102 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,054 |
814 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,743 |
1,220 |
$3K |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
13 |
12 |
$2K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
791 |
742 |
$510.21 |
| A7525 |
Tracheostomy mask, each |
34 |
12 |
$53.19 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
17 |
17 |
$48.52 |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
211 |
50 |
$28.20 |