| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
3,480 |
1,859 |
$1.73M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
3,813 |
2,298 |
$1.41M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,695 |
2,099 |
$196K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,401 |
697 |
$152K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
2,307 |
1,619 |
$132K |
| A7526 |
Tracheostomy tube collar/holder, each |
2,138 |
1,565 |
$99K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
839 |
657 |
$95K |
| E0467 |
Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions |
173 |
89 |
$95K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
2,664 |
1,222 |
$62K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
555 |
393 |
$51K |
| B9998 |
Noc for enteral supplies |
2,015 |
775 |
$51K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,542 |
1,165 |
$43K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,254 |
955 |
$39K |
| A4605 |
Tracheal suction catheter, closed system, each |
432 |
303 |
$22K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,007 |
1,513 |
$17K |
| S8189 |
Tracheostomy supply, not otherwise classified |
165 |
53 |
$13K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,197 |
904 |
$12K |
| A7002 |
Tubing, used with suction pump, each |
2,224 |
1,598 |
$9K |
| 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 |
17 |
12 |
$8K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
680 |
514 |
$8K |
| A4618 |
Breathing circuits |
1,164 |
816 |
$7K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
82 |
65 |
$5K |
| A7001 |
Canister, non-disposable, used with suction pump, each |
284 |
163 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,258 |
1,607 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
317 |
198 |
$3K |
| A7000 |
Canister, disposable, used with suction pump, each |
302 |
234 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
640 |
481 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
73 |
52 |
$2K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
54 |
37 |
$2K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
18 |
13 |
$1K |
| A4623 |
Tracheostomy, inner cannula |
21 |
12 |
$782.09 |
| A7035 |
Headgear used with positive airway pressure device |
59 |
40 |
$595.73 |
| A7525 |
Tracheostomy mask, each |
197 |
143 |
$446.20 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
21 |
12 |
$200.31 |
| A4649 |
Surgical supply; miscellaneous |
94 |
64 |
$196.64 |