| 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 |
6,734 |
4,358 |
$103K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
4,278 |
2,945 |
$77K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,401 |
1,694 |
$61K |
| 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 |
2,806 |
1,985 |
$49K |
| 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 |
1,230 |
871 |
$25K |
| 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 |
1,926 |
1,334 |
$25K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,539 |
2,346 |
$15K |
| E1392 |
Portable oxygen concentrator, rental |
1,459 |
932 |
$4K |
| B9002 |
Enteral nutrition infusion pump, any type |
687 |
554 |
$2K |
| E0570 |
Nebulizer, with compressor |
1,788 |
1,306 |
$2K |
| E0601 |
Continuous positive airway pressure (cpap) device |
106 |
77 |
$2K |
| E0776 |
Iv pole |
249 |
150 |
$170.38 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
25 |
24 |
$132.53 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
84 |
50 |
$27.06 |
| A7037 |
Tubing used with positive airway pressure device |
18 |
14 |
$6.66 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
68 |
54 |
$0.00 |