| 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 |
21,992 |
21,906 |
$1.37M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
432 |
432 |
$127K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,626 |
1,583 |
$102K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,780 |
8,748 |
$101K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,514 |
2,504 |
$98K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,117 |
3,095 |
$95K |
| 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 |
953 |
928 |
$82K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,291 |
3,274 |
$80K |
| E1392 |
Portable oxygen concentrator, rental |
2,011 |
2,004 |
$60K |
| 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 |
764 |
743 |
$43K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,673 |
1,666 |
$41K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,119 |
2,109 |
$39K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,550 |
3,528 |
$34K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
726 |
710 |
$29K |
| A7035 |
Headgear used with positive airway pressure device |
3,125 |
3,109 |
$27K |
| E0570 |
Nebulizer, with compressor |
2,286 |
2,279 |
$19K |
| A7037 |
Tubing used with positive airway pressure device |
3,316 |
3,304 |
$18K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
7,019 |
6,967 |
$15K |
| 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 |
26 |
25 |
$11K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,463 |
1,457 |
$10K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
347 |
344 |
$7K |
| B9002 |
Enteral nutrition infusion pump, any type |
370 |
370 |
$6K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
25 |
24 |
$5K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,859 |
1,857 |
$4K |
| 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) |
51 |
51 |
$1K |
| E0776 |
Iv pole |
259 |
259 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
579 |
578 |
$950.05 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
452 |
435 |
$568.78 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
38 |
38 |
$220.94 |