| 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 |
8,219 |
7,719 |
$348K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
915 |
871 |
$270K |
| 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 |
294 |
290 |
$55K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,521 |
1,493 |
$48K |
| A7030 |
Full face mask used with positive airway pressure device, each |
427 |
422 |
$36K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,459 |
3,254 |
$31K |
| E0601 |
Continuous positive airway pressure (cpap) device |
651 |
628 |
$22K |
| E1392 |
Portable oxygen concentrator, rental |
2,642 |
2,429 |
$21K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,333 |
1,291 |
$16K |
| 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) |
92 |
90 |
$12K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,445 |
2,366 |
$10K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
239 |
237 |
$7K |
| E0570 |
Nebulizer, with compressor |
1,056 |
1,024 |
$5K |
| A7035 |
Headgear used with positive airway pressure device |
281 |
275 |
$5K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
33 |
24 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
178 |
176 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
113 |
113 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
76 |
67 |
$71.19 |