| 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 |
4,742 |
3,784 |
$162K |
| E0570 |
Nebulizer, with compressor |
1,972 |
1,544 |
$43K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,037 |
2,420 |
$23K |
| E0601 |
Continuous positive airway pressure (cpap) device |
643 |
548 |
$21K |
| 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 |
71 |
49 |
$11K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
734 |
626 |
$10K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
564 |
435 |
$4K |
| K0001 |
Standard wheelchair |
73 |
50 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
492 |
413 |
$483.84 |
| A7030 |
Full face mask used with positive airway pressure device, each |
19 |
12 |
$408.58 |
| A7015 |
Aerosol mask, used with dme nebulizer |
267 |
242 |
$260.35 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
13 |
12 |
$191.02 |
| A7031 |
Face mask interface, replacement for full face mask, each |
14 |
12 |
$182.66 |
| A7035 |
Headgear used with positive airway pressure device |
14 |
12 |
$154.91 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
55 |
40 |
$42.09 |