| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
2,238 |
1,945 |
$974K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,956 |
4,557 |
$326K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,670 |
2,827 |
$100K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,844 |
3,546 |
$56K |
| E0570 |
Nebulizer, with compressor |
2,079 |
1,561 |
$38K |
| K0001 |
Standard wheelchair |
1,692 |
1,387 |
$34K |
| A7037 |
Tubing used with positive airway pressure device |
1,178 |
861 |
$12K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
315 |
258 |
$12K |
| 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 |
57 |
49 |
$11K |
| A7031 |
Face mask interface, replacement for full face mask, each |
509 |
411 |
$10K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
70 |
60 |
$7K |
| A7035 |
Headgear used with positive airway pressure device |
676 |
501 |
$6K |
| E0619 |
Apnea monitor, with recording feature |
26 |
25 |
$5K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
32 |
26 |
$4K |
| A7030 |
Full face mask used with positive airway pressure device, each |
69 |
53 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
417 |
338 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
928 |
751 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
52 |
38 |
$893.12 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
220 |
204 |
$680.84 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
162 |
111 |
$472.16 |
| A7015 |
Aerosol mask, used with dme nebulizer |
178 |
160 |
$186.61 |
| A7002 |
Tubing, used with suction pump, each |
52 |
36 |
$136.29 |
| A7000 |
Canister, disposable, used with suction pump, each |
17 |
12 |
$108.98 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
16 |
12 |
$72.80 |