| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
10,512 |
6,605 |
$5.79M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
4,401 |
3,452 |
$2.13M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
20,353 |
16,555 |
$1.53M |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
6,253 |
5,131 |
$1.27M |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
4,661 |
2,756 |
$853K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
8,224 |
3,738 |
$843K |
| Y2032 |
|
2,789 |
1,948 |
$607K |
| A4605 |
Tracheal suction catheter, closed system, each |
4,356 |
2,697 |
$370K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
20,704 |
7,539 |
$368K |
| A4217 |
Sterile water/saline, 500 ml |
4,848 |
3,368 |
$285K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,522 |
1,799 |
$282K |
| A7526 |
Tracheostomy tube collar/holder, each |
7,781 |
5,139 |
$279K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,322 |
9,661 |
$273K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
4,099 |
2,789 |
$248K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
904 |
699 |
$192K |
| S8189 |
Tracheostomy supply, not otherwise classified |
1,674 |
803 |
$173K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,884 |
765 |
$151K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
703 |
533 |
$148K |
| E0619 |
Apnea monitor, with recording feature |
871 |
696 |
$137K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
2,623 |
2,020 |
$132K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,886 |
1,711 |
$95K |
| A7000 |
Canister, disposable, used with suction pump, each |
9,806 |
6,982 |
$94K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
3,918 |
2,149 |
$84K |
| A4556 |
Electrodes, (e.g., apnea monitor), per pair |
1,009 |
532 |
$82K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
6,976 |
4,685 |
$79K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
742 |
499 |
$75K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
1,943 |
1,191 |
$69K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,231 |
2,607 |
$66K |
| A7002 |
Tubing, used with suction pump, each |
9,144 |
6,627 |
$58K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,188 |
794 |
$51K |
| E1399 |
Durable medical equipment, miscellaneous |
274 |
198 |
$46K |
| A4927 |
Gloves, non-sterile, per 100 |
4,857 |
3,556 |
$45K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,072 |
749 |
$41K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
6,736 |
4,911 |
$40K |
| E0570 |
Nebulizer, with compressor |
795 |
518 |
$35K |
| B9998 |
Noc for enteral supplies |
1,077 |
536 |
$34K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
2,017 |
1,680 |
$29K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
485 |
413 |
$28K |
| A4623 |
Tracheostomy, inner cannula |
787 |
417 |
$26K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
5,072 |
3,438 |
$25K |
| A7037 |
Tubing used with positive airway pressure device |
1,966 |
1,244 |
$25K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
8,905 |
4,426 |
$19K |
| E0467 |
Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions |
85 |
50 |
$18K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
2,141 |
1,562 |
$15K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
472 |
410 |
$14K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
410 |
269 |
$14K |
| 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) |
126 |
106 |
$11K |
| A7035 |
Headgear used with positive airway pressure device |
503 |
399 |
$8K |
| A4245 |
Alcohol wipes, per box |
1,162 |
761 |
$8K |
| A4618 |
Breathing circuits |
1,444 |
810 |
$7K |
| A7525 |
Tracheostomy mask, each |
3,719 |
1,724 |
$7K |
| B9002 |
Enteral nutrition infusion pump, any type |
71 |
56 |
$6K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
69 |
63 |
$5K |
| A4557 |
Lead wires, (e.g., apnea monitor), per pair |
788 |
406 |
$5K |
| A7030 |
Full face mask used with positive airway pressure device, each |
79 |
57 |
$4K |
| A4402 |
Lubricant, per ounce |
2,167 |
1,563 |
$4K |
| A7045 |
Exhalation port with or without swivel used with accessories for positive airway devices, replacement only |
358 |
202 |
$3K |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
1,076 |
682 |
$3K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
188 |
108 |
$3K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
1,960 |
1,330 |
$3K |
| A4616 |
Tubing (oxygen), per foot |
102 |
59 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,186 |
1,055 |
$3K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
710 |
290 |
$2K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
167 |
123 |
$2K |
| A4452 |
Tape, waterproof, per 18 square inches |
298 |
244 |
$2K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
63 |
57 |
$2K |
| L8501 |
Tracheostomy speaking valve |
36 |
26 |
$2K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
245 |
158 |
$1K |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
557 |
440 |
$947.50 |
| A4615 |
Cannula, nasal |
1,040 |
560 |
$925.80 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
189 |
145 |
$919.29 |
| A7012 |
Water collection device, used with large volume nebulizer |
486 |
190 |
$829.87 |
| A4244 |
Alcohol or peroxide, per pint |
171 |
110 |
$431.50 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
61 |
54 |
$377.01 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
228 |
176 |
$281.21 |
| A7018 |
Water, distilled, used with large volume nebulizer, 1000 ml |
26 |
25 |
$22.75 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
45 |
27 |
$21.38 |
| XZERO |
|
17 |
12 |
$0.00 |