| 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 |
11,540 |
10,407 |
$383K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,203 |
5,615 |
$166K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,776 |
3,460 |
$90K |
| A7030 |
Full face mask used with positive airway pressure device, each |
498 |
432 |
$26K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,620 |
3,350 |
$17K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
689 |
610 |
$15K |
| A7031 |
Face mask interface, replacement for full face mask, each |
563 |
495 |
$14K |
| A7035 |
Headgear used with positive airway pressure device |
931 |
835 |
$12K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
415 |
362 |
$11K |
| A7037 |
Tubing used with positive airway pressure device |
933 |
821 |
$11K |
| 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 |
129 |
100 |
$9K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
94 |
65 |
$7K |
| E0570 |
Nebulizer, with compressor |
1,910 |
1,737 |
$6K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
488 |
445 |
$3K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
328 |
285 |
$3K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
19 |
16 |
$290.60 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
32 |
28 |
$82.18 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
31 |
25 |
$26.94 |