| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
857 |
803 |
$660K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,096 |
4,006 |
$484K |
| 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) |
411 |
385 |
$212K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,794 |
1,742 |
$201K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,616 |
1,562 |
$113K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
640 |
617 |
$68K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,565 |
1,514 |
$65K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
227 |
213 |
$62K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,669 |
2,605 |
$53K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
153 |
103 |
$51K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,389 |
1,336 |
$38K |
| E0570 |
Nebulizer, with compressor |
372 |
372 |
$36K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,257 |
1,173 |
$33K |
| K0001 |
Standard wheelchair |
800 |
796 |
$27K |
| A7002 |
Tubing, used with suction pump, each |
1,392 |
1,224 |
$22K |
| B9998 |
Noc for enteral supplies |
353 |
295 |
$22K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
146 |
139 |
$18K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
55 |
50 |
$16K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,018 |
973 |
$15K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
691 |
665 |
$9K |
| A7035 |
Headgear used with positive airway pressure device |
198 |
196 |
$6K |
| 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 |
15 |
14 |
$6K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
305 |
286 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
365 |
359 |
$5K |
| A4322 |
Irrigation syringe, bulb or piston, each |
61 |
58 |
$5K |
| E1235 |
Wheelchair, pediatric size, rigid, adjustable, with seating system |
104 |
104 |
$5K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
56 |
52 |
$4K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
28 |
27 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
619 |
606 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
491 |
461 |
$1K |
| B9002 |
Enteral nutrition infusion pump, any type |
13 |
13 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
681 |
664 |
$1K |
| A7526 |
Tracheostomy tube collar/holder, each |
12 |
12 |
$1K |
| E0776 |
Iv pole |
58 |
50 |
$944.04 |
| A4629 |
Tracheostomy care kit for established tracheostomy |
13 |
12 |
$789.33 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
13 |
13 |
$764.65 |
| A7037 |
Tubing used with positive airway pressure device |
12 |
12 |
$257.76 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
13 |
13 |
$0.00 |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
13 |
13 |
$0.00 |