| 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 |
21,546 |
19,953 |
$726K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,822 |
1,543 |
$307K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
10,177 |
9,328 |
$306K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
767 |
668 |
$178K |
| 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 |
942 |
902 |
$165K |
| E0483 |
High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each |
693 |
511 |
$111K |
| 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 |
175 |
153 |
$65K |
| B9002 |
Enteral nutrition infusion pump, any type |
382 |
343 |
$50K |
| E0601 |
Continuous positive airway pressure (cpap) device |
696 |
616 |
$14K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,554 |
2,345 |
$13K |
| E1392 |
Portable oxygen concentrator, rental |
1,293 |
1,229 |
$10K |
| A7030 |
Full face mask used with positive airway pressure device, each |
157 |
141 |
$10K |
| 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 |
61 |
48 |
$9K |
| A7031 |
Face mask interface, replacement for full face mask, each |
312 |
277 |
$8K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
107 |
92 |
$6K |
| E0570 |
Nebulizer, with compressor |
1,660 |
1,564 |
$4K |
| A7037 |
Tubing used with positive airway pressure device |
257 |
237 |
$4K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
281 |
249 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
209 |
194 |
$3K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
136 |
131 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,093 |
957 |
$791.76 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
85 |
77 |
$528.90 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
27 |
26 |
$252.75 |
| J7626 |
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg |
15 |
12 |
$233.12 |
| B9998 |
Noc for enteral supplies |
25 |
13 |
$26.98 |