| 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 |
40,377 |
28,157 |
$846K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,522 |
1,105 |
$417K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
25,274 |
18,366 |
$128K |
| E0570 |
Nebulizer, with compressor |
6,880 |
5,645 |
$67K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,868 |
2,243 |
$48K |
| 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 |
915 |
689 |
$47K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
573 |
434 |
$31K |
| K0001 |
Standard wheelchair |
3,165 |
2,556 |
$26K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
853 |
648 |
$22K |
| A7030 |
Full face mask used with positive airway pressure device, each |
538 |
446 |
$21K |
| E1392 |
Portable oxygen concentrator, rental |
2,067 |
1,646 |
$21K |
| 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 |
437 |
331 |
$21K |
| A7031 |
Face mask interface, replacement for full face mask, each |
782 |
665 |
$15K |
| E0601 |
Continuous positive airway pressure (cpap) device |
539 |
442 |
$14K |
| 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 |
57 |
49 |
$9K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
755 |
623 |
$6K |
| A7035 |
Headgear used with positive airway pressure device |
636 |
522 |
$6K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
348 |
273 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,007 |
2,527 |
$5K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
835 |
620 |
$5K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
248 |
186 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
890 |
769 |
$4K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
188 |
156 |
$4K |
| A7037 |
Tubing used with positive airway pressure device |
674 |
567 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,138 |
2,364 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
777 |
672 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
341 |
266 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
118 |
91 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
75 |
71 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
644 |
565 |
$904.92 |