| 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 |
68,976 |
43,510 |
$2.05M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,452 |
1,424 |
$448K |
| A7030 |
Full face mask used with positive airway pressure device, each |
4,993 |
3,790 |
$242K |
| E0601 |
Continuous positive airway pressure (cpap) device |
6,060 |
4,385 |
$215K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
38,464 |
24,551 |
$206K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,034 |
1,570 |
$151K |
| A7031 |
Face mask interface, replacement for full face mask, each |
5,147 |
4,088 |
$137K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,137 |
3,450 |
$111K |
| E1392 |
Portable oxygen concentrator, rental |
11,492 |
6,956 |
$105K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,124 |
2,405 |
$98K |
| E0570 |
Nebulizer, with compressor |
13,308 |
8,695 |
$98K |
| A7035 |
Headgear used with positive airway pressure device |
5,703 |
4,430 |
$66K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
6,690 |
4,878 |
$59K |
| 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 |
568 |
512 |
$53K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,845 |
1,518 |
$52K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,306 |
1,542 |
$47K |
| A7037 |
Tubing used with positive airway pressure device |
5,264 |
4,014 |
$44K |
| 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 |
1,405 |
916 |
$36K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
17,751 |
12,219 |
$35K |
| K0001 |
Standard wheelchair |
2,955 |
2,023 |
$29K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,553 |
2,925 |
$28K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
991 |
786 |
$17K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
298 |
231 |
$7K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
212 |
132 |
$5K |
| 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) |
65 |
39 |
$4K |
| E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
181 |
130 |
$3K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
793 |
572 |
$3K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
590 |
471 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,774 |
2,690 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
847 |
580 |
$2K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
838 |
682 |
$2K |
| E0156 |
Seat attachment, walker |
66 |
43 |
$424.65 |
| 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 |
19 |
12 |
$337.13 |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
95 |
66 |
$303.57 |