| 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 |
7,333 |
7,230 |
$306K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,158 |
4,099 |
$37K |
| A7031 |
Face mask interface, replacement for full face mask, each |
260 |
256 |
$9K |
| E0601 |
Continuous positive airway pressure (cpap) device |
282 |
277 |
$7K |
| A7037 |
Tubing used with positive airway pressure device |
512 |
501 |
$7K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
12 |
12 |
$6K |
| A7030 |
Full face mask used with positive airway pressure device, each |
89 |
89 |
$4K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
82 |
65 |
$4K |
| 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 |
97 |
74 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
689 |
677 |
$2K |
| E0570 |
Nebulizer, with compressor |
274 |
270 |
$390.29 |
| E1392 |
Portable oxygen concentrator, rental |
326 |
325 |
$374.71 |
| K0001 |
Standard wheelchair |
14 |
12 |
$146.73 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
80 |
76 |
$81.01 |