| 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 |
35,867 |
33,967 |
$2.76M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
996 |
956 |
$364K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
18,398 |
17,291 |
$299K |
| 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 |
632 |
560 |
$101K |
| E1392 |
Portable oxygen concentrator, rental |
5,938 |
5,740 |
$72K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
304 |
234 |
$66K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,099 |
2,028 |
$64K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,400 |
1,366 |
$56K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,487 |
1,462 |
$36K |
| E0570 |
Nebulizer, with compressor |
7,574 |
7,533 |
$34K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,457 |
1,419 |
$31K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
907 |
873 |
$29K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,560 |
1,520 |
$25K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,742 |
1,666 |
$23K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,764 |
4,587 |
$19K |
| A7035 |
Headgear used with positive airway pressure device |
1,778 |
1,737 |
$18K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
496 |
488 |
$12K |
| A7037 |
Tubing used with positive airway pressure device |
1,374 |
1,358 |
$10K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,622 |
1,596 |
$9K |
| 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 |
61 |
49 |
$9K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
315 |
302 |
$7K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
984 |
954 |
$7K |
| B9002 |
Enteral nutrition infusion pump, any type |
76 |
51 |
$5K |
| E0444 |
Portable oxygen contents, liquid, 1 month's supply = 1 unit |
201 |
167 |
$4K |
| E0442 |
Stationary oxygen contents, liquid, 1 month's supply = 1 unit |
162 |
162 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,212 |
3,040 |
$3K |
| K0001 |
Standard wheelchair |
74 |
69 |
$848.00 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
78 |
77 |
$819.31 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
222 |
221 |
$520.07 |
| A7015 |
Aerosol mask, used with dme nebulizer |
706 |
666 |
$448.76 |
| E0776 |
Iv pole |
67 |
51 |
$422.96 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
13 |
13 |
$399.20 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
320 |
313 |
$96.86 |