| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
4,004 |
2,994 |
$1.31M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
35,440 |
26,332 |
$1.29M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
6,392 |
4,848 |
$571K |
| 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 |
1,975 |
1,603 |
$422K |
| A7030 |
Full face mask used with positive airway pressure device, each |
5,870 |
4,598 |
$348K |
| E0601 |
Continuous positive airway pressure (cpap) device |
9,968 |
7,848 |
$321K |
| A7031 |
Face mask interface, replacement for full face mask, each |
9,626 |
8,049 |
$310K |
| 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 |
527 |
415 |
$295K |
| 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 |
5,054 |
3,574 |
$275K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
17,256 |
13,087 |
$156K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
4,154 |
2,918 |
$147K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,009 |
732 |
$145K |
| E1392 |
Portable oxygen concentrator, rental |
9,914 |
7,540 |
$135K |
| 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 |
2,423 |
1,691 |
$127K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
9,975 |
7,940 |
$121K |
| B9002 |
Enteral nutrition infusion pump, any type |
2,411 |
1,974 |
$98K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
2,342 |
1,814 |
$79K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,515 |
2,075 |
$73K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,218 |
1,824 |
$71K |
| E0570 |
Nebulizer, with compressor |
11,814 |
8,148 |
$69K |
| A7035 |
Headgear used with positive airway pressure device |
5,061 |
3,899 |
$60K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
14,963 |
12,303 |
$54K |
| A7037 |
Tubing used with positive airway pressure device |
5,499 |
4,277 |
$54K |
| 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) |
391 |
316 |
$33K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,249 |
1,061 |
$33K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,474 |
1,054 |
$29K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,826 |
2,955 |
$26K |
| E1130 |
Standard wheelchair, fixed full length arms, fixed or swing away detachable footrests |
624 |
551 |
$19K |
| E0776 |
Iv pole |
3,150 |
2,377 |
$16K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
828 |
589 |
$15K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
43 |
36 |
$14K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
441 |
330 |
$11K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
361 |
291 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
4,909 |
3,837 |
$5K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
431 |
368 |
$3K |
| B9998 |
Noc for enteral supplies |
157 |
127 |
$2K |
| E0156 |
Seat attachment, walker |
223 |
174 |
$2K |
| A7000 |
Canister, disposable, used with suction pump, each |
95 |
70 |
$1K |
| K0001 |
Standard wheelchair |
1,701 |
1,449 |
$1K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
18 |
14 |
$1K |
| A7526 |
Tracheostomy tube collar/holder, each |
40 |
25 |
$1K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
1,217 |
970 |
$351.89 |
| A7015 |
Aerosol mask, used with dme nebulizer |
645 |
489 |
$327.60 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
34 |
28 |
$272.13 |