| 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 |
9,352 |
9,245 |
$383K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,145 |
6,054 |
$56K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
121 |
112 |
$20K |
| 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 |
98 |
93 |
$14K |
| E0570 |
Nebulizer, with compressor |
3,369 |
3,333 |
$14K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
364 |
346 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
62 |
55 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,573 |
1,486 |
$1K |
| E1392 |
Portable oxygen concentrator, rental |
148 |
147 |
$1K |
| A7031 |
Face mask interface, replacement for full face mask, each |
49 |
44 |
$1K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
23 |
19 |
$697.17 |
| E0601 |
Continuous positive airway pressure (cpap) device |
39 |
38 |
$561.71 |
| A7037 |
Tubing used with positive airway pressure device |
63 |
57 |
$477.52 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
49 |
49 |
$343.17 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
29 |
26 |
$108.43 |
| A7035 |
Headgear used with positive airway pressure device |
16 |
13 |
$104.59 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
12 |
12 |
$34.51 |