| 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 |
4,834 |
4,809 |
$388K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
5,172 |
1,149 |
$184K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
842 |
828 |
$103K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,368 |
4,342 |
$70K |
| H2015 |
Comprehensive community support services, per 15 minutes |
1,328 |
641 |
$57K |
| E0570 |
Nebulizer, with compressor |
1,330 |
1,325 |
$55K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
1,828 |
1,818 |
$52K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
832 |
832 |
$46K |
| H0043 |
Supported housing, per diem |
432 |
227 |
$23K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
59 |
59 |
$21K |
| S9500 |
Home infusion therapy, antibiotic, antiviral, or antifungal therapy; once every 24 hours; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
170 |
52 |
$18K |
| H0032 |
Mental health service plan development by non-physician |
1,024 |
515 |
$16K |
| E0601 |
Continuous positive airway pressure (cpap) device |
270 |
264 |
$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 |
100 |
86 |
$9K |
| K0001 |
Standard wheelchair |
383 |
383 |
$9K |
| L3260 |
Surgical boot/shoe, each |
105 |
104 |
$4K |
| B9002 |
Enteral nutrition infusion pump, any type |
44 |
39 |
$3K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
152 |
149 |
$2K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
16 |
15 |
$1K |
| L4350 |
Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
15 |
15 |
$986.72 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
315 |
313 |
$900.97 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
306 |
304 |
$608.32 |
| A7035 |
Headgear used with positive airway pressure device |
24 |
24 |
$410.94 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
13 |
13 |
$102.28 |
| E0776 |
Iv pole |
12 |
12 |
$86.01 |
| A7015 |
Aerosol mask, used with dme nebulizer |
16 |
16 |
$16.68 |
| A4565 |
Slings |
12 |
12 |
$0.00 |