| 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 |
46,635 |
36,269 |
$1.91M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,476 |
1,780 |
$783K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
5,284 |
4,467 |
$345K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
28,125 |
21,868 |
$229K |
| 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 |
2,103 |
1,702 |
$140K |
| 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 |
1,785 |
1,545 |
$139K |
| 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 |
819 |
710 |
$136K |
| A7030 |
Full face mask used with positive airway pressure device, each |
2,457 |
1,938 |
$112K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,375 |
1,934 |
$111K |
| A7031 |
Face mask interface, replacement for full face mask, each |
3,124 |
2,590 |
$73K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,878 |
1,547 |
$65K |
| E1392 |
Portable oxygen concentrator, rental |
5,367 |
4,052 |
$53K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
9,164 |
8,257 |
$45K |
| A7035 |
Headgear used with positive airway pressure device |
3,228 |
2,702 |
$45K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,140 |
1,733 |
$43K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,625 |
1,249 |
$41K |
| E0570 |
Nebulizer, with compressor |
6,511 |
4,390 |
$38K |
| B9002 |
Enteral nutrition infusion pump, any type |
788 |
776 |
$34K |
| A7037 |
Tubing used with positive airway pressure device |
2,344 |
1,894 |
$26K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
157 |
122 |
$25K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,674 |
2,244 |
$19K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
986 |
829 |
$18K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
511 |
448 |
$8K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
962 |
771 |
$8K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
754 |
580 |
$7K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
608 |
551 |
$6K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
1,112 |
653 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,395 |
2,383 |
$4K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
495 |
421 |
$3K |
| E0776 |
Iv pole |
853 |
852 |
$2K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
207 |
207 |
$1K |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
76 |
66 |
$1K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
120 |
120 |
$876.80 |
| A7015 |
Aerosol mask, used with dme nebulizer |
20 |
12 |
$16.48 |