| 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 |
8,333 |
8,274 |
$731K |
| E0601 |
Continuous positive airway pressure (cpap) device |
7,062 |
7,006 |
$367K |
| 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 |
1,462 |
1,413 |
$234K |
| E0570 |
Nebulizer, with compressor |
3,164 |
3,104 |
$124K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,317 |
1,292 |
$90K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,924 |
4,877 |
$79K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,875 |
1,868 |
$70K |
| A7035 |
Headgear used with positive airway pressure device |
1,840 |
1,821 |
$33K |
| A7037 |
Tubing used with positive airway pressure device |
1,276 |
1,263 |
$29K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
540 |
539 |
$24K |
| K0001 |
Standard wheelchair |
935 |
914 |
$22K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
359 |
335 |
$18K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,111 |
1,103 |
$17K |
| 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 |
387 |
344 |
$14K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,376 |
2,340 |
$13K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
511 |
460 |
$8K |
| A7031 |
Face mask interface, replacement for full face mask, each |
329 |
319 |
$7K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
134 |
119 |
$6K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
554 |
518 |
$6K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
440 |
433 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
52 |
51 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
369 |
368 |
$418.60 |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
13 |
12 |
$411.86 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
53 |
53 |
$296.54 |
| A4259 |
Lancets, per box of 100 |
184 |
178 |
$222.37 |
| B9002 |
Enteral nutrition infusion pump, any type |
15 |
13 |
$158.97 |
| E0156 |
Seat attachment, walker |
13 |
13 |
$114.70 |