| 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 |
15,546 |
12,450 |
$304K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,187 |
716 |
$184K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
553 |
457 |
$172K |
| E2402 |
Negative pressure wound therapy electrical pump, stationary or portable |
616 |
390 |
$144K |
| 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 |
973 |
568 |
$142K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
7,102 |
5,940 |
$58K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,437 |
2,979 |
$51K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,221 |
825 |
$37K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
395 |
257 |
$30K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,292 |
1,775 |
$27K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,299 |
890 |
$26K |
| E1392 |
Portable oxygen concentrator, rental |
3,261 |
2,731 |
$22K |
| E0570 |
Nebulizer, with compressor |
2,318 |
2,031 |
$18K |
| B4100 |
Food thickener, administered orally, per ounce |
456 |
350 |
$16K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,119 |
627 |
$15K |
| A7035 |
Headgear used with positive airway pressure device |
2,055 |
1,378 |
$14K |
| A7031 |
Face mask interface, replacement for full face mask, each |
991 |
645 |
$12K |
| A7037 |
Tubing used with positive airway pressure device |
2,263 |
1,500 |
$11K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
638 |
525 |
$10K |
| K0001 |
Standard wheelchair |
1,549 |
1,099 |
$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 |
20 |
13 |
$9K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,562 |
2,373 |
$7K |
| A6550 |
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories |
80 |
43 |
$5K |
| B9002 |
Enteral nutrition infusion pump, any type |
87 |
82 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
265 |
210 |
$5K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
975 |
689 |
$5K |
| A7526 |
Tracheostomy tube collar/holder, each |
32 |
26 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
130 |
92 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
37 |
29 |
$2K |
| 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 |
23 |
13 |
$905.80 |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
34 |
24 |
$846.72 |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
13 |
13 |
$694.44 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
56 |
42 |
$560.10 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
28 |
25 |
$437.44 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
92 |
60 |
$380.98 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
30 |
25 |
$376.80 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
438 |
332 |
$189.19 |
| E0156 |
Seat attachment, walker |
22 |
12 |
$102.74 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
28 |
12 |
$25.36 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
50 |
40 |
$13.14 |