| 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 |
19,051 |
11,099 |
$329K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,692 |
839 |
$254K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,437 |
2,585 |
$97K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,656 |
7,055 |
$51K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,362 |
1,367 |
$38K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,676 |
871 |
$32K |
| 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 |
981 |
733 |
$30K |
| 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 |
990 |
686 |
$24K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
616 |
436 |
$24K |
| E0570 |
Nebulizer, with compressor |
7,475 |
4,628 |
$18K |
| E1392 |
Portable oxygen concentrator, rental |
3,561 |
2,020 |
$15K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,423 |
847 |
$14K |
| E0442 |
Stationary oxygen contents, liquid, 1 month's supply = 1 unit |
1,955 |
813 |
$7K |
| B9002 |
Enteral nutrition infusion pump, any type |
713 |
632 |
$7K |
| A7037 |
Tubing used with positive airway pressure device |
2,391 |
1,262 |
$7K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,042 |
2,346 |
$6K |
| A7035 |
Headgear used with positive airway pressure device |
1,588 |
825 |
$6K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
587 |
433 |
$5K |
| E0444 |
Portable oxygen contents, liquid, 1 month's supply = 1 unit |
1,365 |
537 |
$5K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
578 |
286 |
$4K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
669 |
229 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
954 |
453 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,715 |
1,456 |
$1K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
99 |
55 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
150 |
87 |
$508.73 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
17 |
12 |
$190.00 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
50 |
12 |
$20.02 |
| A7015 |
Aerosol mask, used with dme nebulizer |
18 |
13 |
$6.07 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
17 |
13 |
$2.92 |