| 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 |
36,339 |
28,448 |
$1.38M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
20,504 |
16,047 |
$161K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,012 |
3,065 |
$143K |
| A7030 |
Full face mask used with positive airway pressure device, each |
3,733 |
2,724 |
$141K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
681 |
442 |
$122K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,837 |
2,879 |
$98K |
| 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 |
707 |
678 |
$93K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,595 |
3,585 |
$92K |
| E1392 |
Portable oxygen concentrator, rental |
6,253 |
4,692 |
$64K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,681 |
2,761 |
$61K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,777 |
2,002 |
$61K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
13,939 |
11,885 |
$59K |
| A7035 |
Headgear used with positive airway pressure device |
5,193 |
4,062 |
$58K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
2,798 |
2,138 |
$53K |
| 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 |
69 |
63 |
$36K |
| E0570 |
Nebulizer, with compressor |
7,221 |
4,833 |
$33K |
| A7037 |
Tubing used with positive airway pressure device |
4,049 |
2,997 |
$32K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
4,282 |
3,334 |
$26K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,555 |
1,270 |
$23K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
54 |
50 |
$21K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
177 |
144 |
$19K |
| 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) |
252 |
182 |
$13K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,293 |
947 |
$10K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
1,876 |
1,064 |
$10K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
789 |
697 |
$9K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,443 |
1,181 |
$8K |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
247 |
226 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,785 |
1,948 |
$3K |
| K0001 |
Standard wheelchair |
17 |
13 |
$328.99 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
15 |
12 |
$6.11 |