| 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 |
26,350 |
23,136 |
$1.42M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,136 |
1,020 |
$374K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,502 |
10,154 |
$144K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,849 |
1,523 |
$94K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,699 |
1,534 |
$86K |
| A7037 |
Tubing used with positive airway pressure device |
4,799 |
4,320 |
$84K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,716 |
5,135 |
$57K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,159 |
1,886 |
$55K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,124 |
1,018 |
$50K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,820 |
1,643 |
$46K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
880 |
782 |
$39K |
| A7035 |
Headgear used with positive airway pressure device |
1,951 |
1,737 |
$35K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,661 |
1,475 |
$31K |
| 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 |
1,260 |
1,081 |
$29K |
| E1392 |
Portable oxygen concentrator, rental |
2,310 |
2,034 |
$25K |
| E0570 |
Nebulizer, with compressor |
4,029 |
3,698 |
$24K |
| 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 |
577 |
536 |
$19K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
948 |
848 |
$12K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
690 |
598 |
$12K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
881 |
799 |
$11K |
| K0003 |
Lightweight wheelchair |
222 |
208 |
$5K |
| 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) |
27 |
24 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,569 |
1,385 |
$2K |
| K0001 |
Standard wheelchair |
38 |
38 |
$783.21 |
| B9002 |
Enteral nutrition infusion pump, any type |
79 |
63 |
$722.61 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
13 |
12 |
$5.51 |