| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
23,601 |
18,705 |
$19.59M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
24,738 |
23,669 |
$17.11M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
36,796 |
33,837 |
$7.47M |
| 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 |
8,200 |
7,407 |
$5.64M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
53,453 |
52,709 |
$5.19M |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
14,613 |
13,883 |
$2.98M |
| E1399 |
Durable medical equipment, miscellaneous |
25,464 |
15,346 |
$2.85M |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
20,539 |
20,017 |
$2.21M |
| 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 |
8,363 |
7,853 |
$1.96M |
| B9998 |
Noc for enteral supplies |
9,846 |
9,218 |
$1.50M |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
6,066 |
5,986 |
$1.33M |
| A4629 |
Tracheostomy care kit for established tracheostomy |
12,344 |
11,967 |
$1.13M |
| A4605 |
Tracheal suction catheter, closed system, each |
9,083 |
8,768 |
$1.12M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
51,282 |
50,813 |
$1.05M |
| A7526 |
Tracheostomy tube collar/holder, each |
12,582 |
12,125 |
$904K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,489 |
1,341 |
$874K |
| B9002 |
Enteral nutrition infusion pump, any type |
11,964 |
11,710 |
$870K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
12,154 |
11,445 |
$724K |
| 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 |
2,693 |
2,492 |
$671K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
10,423 |
9,982 |
$593K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
4,396 |
4,106 |
$568K |
| 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 |
2,650 |
2,421 |
$442K |
| A7000 |
Canister, disposable, used with suction pump, each |
28,265 |
27,468 |
$426K |
| 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) |
1,899 |
1,882 |
$355K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
5,916 |
5,267 |
$352K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
7,485 |
7,268 |
$333K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
3,413 |
3,369 |
$323K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,592 |
2,477 |
$291K |
| A4623 |
Tracheostomy, inner cannula |
3,434 |
3,248 |
$268K |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
1,153 |
1,039 |
$256K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
15,918 |
15,351 |
$245K |
| 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 |
1,445 |
1,285 |
$235K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
2,731 |
2,659 |
$229K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
20,279 |
19,505 |
$226K |
| A4481 |
Tracheostoma filter, any type, any size, each |
2,373 |
2,301 |
$224K |
| A4927 |
Gloves, non-sterile, per 100 |
18,488 |
17,811 |
$202K |
| A7002 |
Tubing, used with suction pump, each |
28,908 |
27,947 |
$171K |
| L8501 |
Tracheostomy speaking valve |
2,269 |
2,212 |
$166K |
| A4554 |
Disposable underpads, all sizes |
3,390 |
3,263 |
$155K |
| E0619 |
Apnea monitor, with recording feature |
948 |
938 |
$155K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
1,383 |
1,262 |
$150K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
3,127 |
2,937 |
$145K |
| E0570 |
Nebulizer, with compressor |
2,921 |
2,828 |
$116K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
3,802 |
3,743 |
$114K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
614 |
575 |
$109K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
8,961 |
8,547 |
$106K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,085 |
2,066 |
$96K |
| A4217 |
Sterile water/saline, 500 ml |
3,368 |
3,249 |
$95K |
| E0776 |
Iv pole |
3,276 |
3,202 |
$91K |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
532 |
507 |
$85K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,041 |
1,007 |
$81K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
22,163 |
21,504 |
$70K |
| 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 |
2,036 |
1,915 |
$65K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
7,685 |
7,418 |
$55K |
| B4082 |
Nasogastric tubing without stylet |
1,221 |
1,112 |
$39K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
767 |
751 |
$36K |
| B4081 |
Nasogastric tubing with stylet |
836 |
797 |
$34K |
| A7525 |
Tracheostomy mask, each |
8,098 |
7,900 |
$31K |
| A4402 |
Lubricant, per ounce |
9,549 |
9,301 |
$31K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
377 |
345 |
$26K |
| S8999 |
Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event) |
388 |
375 |
$23K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
3,007 |
2,806 |
$22K |
| A7020 |
Interface for cough stimulating device, includes all components, replacement only |
2,092 |
2,015 |
$20K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
85 |
81 |
$18K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
108 |
101 |
$13K |
| E1392 |
Portable oxygen concentrator, rental |
458 |
433 |
$12K |
| A4618 |
Breathing circuits |
1,860 |
1,798 |
$12K |
| A7037 |
Tubing used with positive airway pressure device |
884 |
860 |
$11K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
836 |
814 |
$10K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
122 |
121 |
$8K |
| A7035 |
Headgear used with positive airway pressure device |
505 |
499 |
$8K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
3,852 |
3,715 |
$7K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
278 |
263 |
$7K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
689 |
663 |
$7K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
95 |
92 |
$6K |
| A7012 |
Water collection device, used with large volume nebulizer |
1,408 |
1,355 |
$6K |
| A7015 |
Aerosol mask, used with dme nebulizer |
5,172 |
5,034 |
$6K |
| S9340 |
Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
266 |
120 |
$5K |
| A7527 |
Tracheostomy/laryngectomy tube plug/stop, each |
483 |
449 |
$4K |
| A4245 |
Alcohol wipes, per box |
2,161 |
2,075 |
$4K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
108 |
104 |
$3K |
| A5120 |
Skin barrier, wipes or swabs, each |
412 |
383 |
$3K |
| A7018 |
Water, distilled, used with large volume nebulizer, 1000 ml |
474 |
442 |
$2K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
380 |
358 |
$2K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
122 |
114 |
$1K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
13 |
12 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
69 |
68 |
$897.09 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
150 |
148 |
$769.69 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
386 |
379 |
$758.80 |
| A4452 |
Tape, waterproof, per 18 square inches |
151 |
149 |
$519.52 |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
12 |
12 |
$283.08 |
| A7045 |
Exhalation port with or without swivel used with accessories for positive airway devices, replacement only |
12 |
12 |
$149.62 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
241 |
234 |
$103.31 |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
22 |
22 |
$45.90 |