| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,226 |
1,033 |
$645K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
14,535 |
13,659 |
$572K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
990 |
889 |
$356K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,859 |
2,531 |
$320K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,368 |
1,029 |
$278K |
| 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 |
2,507 |
1,452 |
$267K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,766 |
1,678 |
$101K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,087 |
2,934 |
$84K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,351 |
2,236 |
$78K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
1,346 |
1,028 |
$76K |
| B9998 |
Noc for enteral supplies |
2,497 |
1,508 |
$68K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,909 |
8,268 |
$63K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,406 |
910 |
$61K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
239 |
89 |
$40K |
| A7037 |
Tubing used with positive airway pressure device |
2,440 |
2,318 |
$25K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,723 |
1,646 |
$22K |
| A7000 |
Canister, disposable, used with suction pump, each |
2,473 |
1,963 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,099 |
4,788 |
$18K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
1,858 |
1,295 |
$18K |
| A7035 |
Headgear used with positive airway pressure device |
1,391 |
1,295 |
$17K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
605 |
562 |
$15K |
| A7002 |
Tubing, used with suction pump, each |
2,901 |
1,960 |
$13K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
375 |
351 |
$13K |
| E0570 |
Nebulizer, with compressor |
3,501 |
3,276 |
$12K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
335 |
253 |
$12K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
114 |
113 |
$10K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
655 |
611 |
$10K |
| A4605 |
Tracheal suction catheter, closed system, each |
27 |
24 |
$7K |
| A7526 |
Tracheostomy tube collar/holder, each |
652 |
583 |
$7K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
285 |
264 |
$6K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
807 |
771 |
$6K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,707 |
1,376 |
$4K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
367 |
247 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,003 |
2,624 |
$3K |
| A4618 |
Breathing circuits |
280 |
186 |
$3K |
| K0001 |
Standard wheelchair |
422 |
387 |
$3K |
| B9002 |
Enteral nutrition infusion pump, any type |
59 |
50 |
$3K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
470 |
391 |
$2K |
| E1392 |
Portable oxygen concentrator, rental |
285 |
263 |
$2K |
| A7525 |
Tracheostomy mask, each |
968 |
573 |
$775.23 |
| E0776 |
Iv pole |
75 |
67 |
$732.02 |
| A4927 |
Gloves, non-sterile, per 100 |
156 |
135 |
$488.03 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
12 |
12 |
$51.02 |