| 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 |
24,785 |
23,607 |
$886K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
20,563 |
19,788 |
$151K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,661 |
2,533 |
$120K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
516 |
414 |
$96K |
| E0570 |
Nebulizer, with compressor |
2,363 |
2,227 |
$95K |
| E0601 |
Continuous positive airway pressure (cpap) device |
5,946 |
5,748 |
$77K |
| A7526 |
Tracheostomy tube collar/holder, each |
665 |
578 |
$52K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,250 |
2,123 |
$48K |
| K0001 |
Standard wheelchair |
2,149 |
2,054 |
$44K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,099 |
1,043 |
$38K |
| A7037 |
Tubing used with positive airway pressure device |
3,161 |
3,042 |
$31K |
| E0619 |
Apnea monitor, with recording feature |
170 |
161 |
$28K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,483 |
1,424 |
$27K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,282 |
1,197 |
$25K |
| A7035 |
Headgear used with positive airway pressure device |
2,732 |
2,596 |
$24K |
| 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) |
668 |
639 |
$22K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,725 |
1,643 |
$21K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,075 |
6,718 |
$18K |
| 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 |
63 |
51 |
$17K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
719 |
707 |
$12K |
| B9002 |
Enteral nutrition infusion pump, any type |
238 |
214 |
$9K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
454 |
420 |
$8K |
| A7000 |
Canister, disposable, used with suction pump, each |
683 |
588 |
$7K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
479 |
462 |
$7K |
| A7002 |
Tubing, used with suction pump, each |
1,167 |
789 |
$6K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,255 |
1,176 |
$5K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,301 |
1,188 |
$4K |
| E1392 |
Portable oxygen concentrator, rental |
464 |
430 |
$3K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
52 |
49 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
89 |
87 |
$2K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
609 |
475 |
$2K |
| E0776 |
Iv pole |
195 |
177 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
15 |
13 |
$622.31 |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
14 |
12 |
$553.87 |
| A7015 |
Aerosol mask, used with dme nebulizer |
549 |
506 |
$419.99 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
25 |
24 |
$309.13 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
24 |
24 |
$173.55 |
| A7525 |
Tracheostomy mask, each |
55 |
49 |
$81.62 |
| A7012 |
Water collection device, used with large volume nebulizer |
14 |
14 |
$73.57 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
31 |
29 |
$27.28 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
32 |
30 |
$5.94 |