| 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 |
11,452 |
8,388 |
$63K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,623 |
4,740 |
$37K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,380 |
1,611 |
$35K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
744 |
664 |
$28K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,921 |
1,218 |
$14K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,683 |
1,145 |
$5K |
| E1392 |
Portable oxygen concentrator, rental |
2,320 |
1,738 |
$4K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,113 |
1,345 |
$3K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,818 |
1,187 |
$2K |
| 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 |
143 |
108 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
1,495 |
948 |
$765.19 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,312 |
2,168 |
$498.67 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
615 |
418 |
$335.97 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
270 |
171 |
$272.39 |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
36 |
24 |
$266.99 |
| E0570 |
Nebulizer, with compressor |
515 |
344 |
$176.84 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
40 |
25 |
$164.24 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
757 |
497 |
$134.91 |