| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
11,599 |
9,111 |
$9.54M |
| E1399 |
Durable medical equipment, miscellaneous |
4,576 |
4,333 |
$1.93M |
| S8189 |
Tracheostomy supply, not otherwise classified |
11,127 |
9,676 |
$1.72M |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
8,877 |
8,400 |
$1.41M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
8,177 |
6,972 |
$1.32M |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
6,856 |
5,971 |
$1.26M |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
3,718 |
3,655 |
$1.05M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
8,688 |
8,514 |
$1.02M |
| A4649 |
Surgical supply; miscellaneous |
8,123 |
6,835 |
$765K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,236 |
1,147 |
$683K |
| A7526 |
Tracheostomy tube collar/holder, each |
10,810 |
10,438 |
$595K |
| 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 |
1,377 |
1,288 |
$503K |
| 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 |
3,180 |
2,835 |
$466K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
3,589 |
3,470 |
$356K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
5,108 |
4,965 |
$346K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
7,150 |
6,172 |
$346K |
| A4927 |
Gloves, non-sterile, per 100 |
14,591 |
13,754 |
$299K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,057 |
968 |
$287K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
5,244 |
4,859 |
$273K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,094 |
7,957 |
$188K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
6,230 |
5,823 |
$156K |
| L8501 |
Tracheostomy speaking valve |
2,338 |
2,259 |
$154K |
| B9002 |
Enteral nutrition infusion pump, any type |
2,758 |
2,709 |
$154K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
10,003 |
8,870 |
$115K |
| A4623 |
Tracheostomy, inner cannula |
2,591 |
2,449 |
$102K |
| A7000 |
Canister, disposable, used with suction pump, each |
12,975 |
12,226 |
$87K |
| A4605 |
Tracheal suction catheter, closed system, each |
798 |
747 |
$77K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
270 |
270 |
$77K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
612 |
509 |
$76K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
7,802 |
7,409 |
$72K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
1,619 |
716 |
$59K |
| E0570 |
Nebulizer, with compressor |
4,713 |
4,598 |
$57K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
1,756 |
1,735 |
$51K |
| A7002 |
Tubing, used with suction pump, each |
12,039 |
11,538 |
$47K |
| A7525 |
Tracheostomy mask, each |
3,842 |
3,513 |
$44K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,257 |
2,063 |
$41K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
5,337 |
4,970 |
$41K |
| A7509 |
Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each |
1,173 |
1,095 |
$28K |
| A4452 |
Tape, waterproof, per 18 square inches |
3,518 |
3,371 |
$25K |
| A7018 |
Water, distilled, used with large volume nebulizer, 1000 ml |
7,338 |
7,134 |
$24K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,435 |
1,395 |
$22K |
| A4657 |
Syringe, with or without needle, each |
3,376 |
3,076 |
$19K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
769 |
720 |
$19K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
9,428 |
9,154 |
$17K |
| E0776 |
Iv pole |
2,402 |
2,314 |
$17K |
| A7037 |
Tubing used with positive airway pressure device |
418 |
396 |
$15K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
90 |
88 |
$10K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
732 |
720 |
$10K |
| 99503 |
|
182 |
180 |
$9K |
| 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 |
85 |
74 |
$9K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
4,403 |
4,277 |
$8K |
| A7045 |
Exhalation port with or without swivel used with accessories for positive airway devices, replacement only |
495 |
476 |
$8K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
1,825 |
1,740 |
$7K |
| A7012 |
Water collection device, used with large volume nebulizer |
1,702 |
1,640 |
$7K |
| E0601 |
Continuous positive airway pressure (cpap) device |
118 |
98 |
$7K |
| S8186 |
Swivel adapter |
414 |
385 |
$5K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
405 |
388 |
$4K |
| S8999 |
Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event) |
42 |
42 |
$3K |
| B9998 |
Noc for enteral supplies |
89 |
75 |
$2K |
| A4402 |
Lubricant, per ounce |
2,319 |
2,261 |
$2K |
| A4245 |
Alcohol wipes, per box |
791 |
775 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
117 |
97 |
$1K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
265 |
244 |
$936.34 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
90 |
87 |
$921.48 |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
13 |
13 |
$598.35 |
| A7015 |
Aerosol mask, used with dme nebulizer |
286 |
281 |
$398.12 |
| A4618 |
Breathing circuits |
449 |
382 |
$172.53 |
| A4217 |
Sterile water/saline, 500 ml |
411 |
396 |
$117.94 |
| A7020 |
Interface for cough stimulating device, includes all components, replacement only |
12 |
12 |
$94.51 |
| A4244 |
Alcohol or peroxide, per pint |
70 |
70 |
$78.05 |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
47 |
39 |
$70.00 |
| S8210 |
Mucus trap |
26 |
26 |
$59.51 |
| A4332 |
Lubricant, individual sterile packet, each |
1,350 |
1,302 |
$40.99 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
920 |
886 |
$19.50 |
| A4616 |
Tubing (oxygen), per foot |
207 |
175 |
$0.00 |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
13 |
13 |
$0.00 |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
60 |
44 |
$0.00 |