| 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 |
14,418 |
8,493 |
$578K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,570 |
1,930 |
$438K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
3,834 |
2,137 |
$360K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
519 |
190 |
$136K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,053 |
1,797 |
$70K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,208 |
884 |
$69K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
647 |
432 |
$62K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
9,133 |
5,466 |
$62K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,670 |
1,242 |
$46K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
574 |
349 |
$28K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
3,771 |
2,164 |
$24K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
512 |
301 |
$21K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,142 |
766 |
$19K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
74 |
66 |
$18K |
| A7037 |
Tubing used with positive airway pressure device |
1,342 |
1,011 |
$16K |
| A4217 |
Sterile water/saline, 500 ml |
383 |
283 |
$14K |
| E0570 |
Nebulizer, with compressor |
2,837 |
1,844 |
$14K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,454 |
2,763 |
$13K |
| A7035 |
Headgear used with positive airway pressure device |
1,019 |
769 |
$12K |
| A4623 |
Tracheostomy, inner cannula |
303 |
171 |
$12K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,638 |
1,122 |
$10K |
| 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 |
47 |
44 |
$6K |
| A7002 |
Tubing, used with suction pump, each |
1,869 |
1,126 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,329 |
1,021 |
$2K |
| L8501 |
Tracheostomy speaking valve |
22 |
14 |
$2K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
288 |
229 |
$1K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
77 |
56 |
$1K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
23 |
12 |
$880.42 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
14 |
13 |
$785.90 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
149 |
109 |
$589.19 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
52 |
24 |
$572.01 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
18 |
12 |
$288.49 |
| A7525 |
Tracheostomy mask, each |
371 |
203 |
$255.23 |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
107 |
54 |
$209.89 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
22 |
12 |
$23.18 |