| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,127 |
1,830 |
$507K |
| 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 |
631 |
506 |
$282K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,429 |
1,222 |
$152K |
| 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 |
807 |
683 |
$136K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,710 |
1,624 |
$130K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
440 |
328 |
$128K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,017 |
870 |
$82K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,467 |
1,313 |
$54K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
152 |
92 |
$30K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,721 |
1,529 |
$22K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
1,165 |
1,047 |
$20K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,286 |
1,221 |
$18K |
| E0570 |
Nebulizer, with compressor |
158 |
145 |
$15K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
528 |
489 |
$13K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
124 |
108 |
$12K |
| A7031 |
Face mask interface, replacement for full face mask, each |
250 |
234 |
$12K |
| A4335 |
Incontinence supply; miscellaneous |
646 |
578 |
$11K |
| A7030 |
Full face mask used with positive airway pressure device, each |
142 |
130 |
$10K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
57 |
48 |
$10K |
| E0776 |
Iv pole |
857 |
720 |
$9K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
241 |
212 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
453 |
421 |
$7K |
| B9998 |
Noc for enteral supplies |
61 |
50 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
562 |
509 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
697 |
619 |
$4K |
| K0001 |
Standard wheelchair |
253 |
223 |
$4K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
13 |
12 |
$3K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
63 |
50 |
$3K |
| T4541 |
Incontinence product, disposable underpad, large, each |
46 |
38 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
146 |
117 |
$2K |
| A7000 |
Canister, disposable, used with suction pump, each |
77 |
71 |
$2K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
17 |
14 |
$1K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
14 |
12 |
$1K |
| A7002 |
Tubing, used with suction pump, each |
122 |
109 |
$957.21 |
| A7015 |
Aerosol mask, used with dme nebulizer |
390 |
339 |
$697.43 |
| B4100 |
Food thickener, administered orally, per ounce |
16 |
12 |
$673.29 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
22 |
14 |
$624.62 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
87 |
29 |
$551.71 |
| T4542 |
Incontinence product, disposable underpad, small size, each |
20 |
17 |
$530.31 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
12 |
12 |
$485.28 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
62 |
60 |
$386.77 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
14 |
13 |
$207.00 |