| 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 |
8,531 |
4,301 |
$286K |
| 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 |
4,204 |
2,092 |
$64K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,608 |
1,871 |
$49K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
275 |
135 |
$42K |
| E0570 |
Nebulizer, with compressor |
434 |
235 |
$17K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,538 |
854 |
$12K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
571 |
260 |
$6K |
| 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 |
22 |
12 |
$4K |
| E1392 |
Portable oxygen concentrator, rental |
253 |
172 |
$4K |
| A7035 |
Headgear used with positive airway pressure device |
441 |
204 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
671 |
336 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
129 |
68 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
164 |
98 |
$1K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
26 |
13 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
33 |
14 |
$220.26 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
160 |
103 |
$140.53 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
29 |
13 |
$102.14 |