| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
7,115 |
6,871 |
$1.20M |
| 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 |
1,717 |
1,659 |
$1.19M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
9,352 |
8,714 |
$1.08M |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
2,266 |
1,996 |
$1.00M |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
6,589 |
6,295 |
$954K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
11,567 |
8,410 |
$850K |
| B9002 |
Enteral nutrition infusion pump, any type |
8,819 |
8,358 |
$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 |
2,300 |
2,255 |
$471K |
| 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 |
1,765 |
1,692 |
$409K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
5,493 |
5,237 |
$335K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
14,177 |
9,440 |
$322K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
4,565 |
4,433 |
$315K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
531 |
487 |
$261K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
9,349 |
8,710 |
$251K |
| A4322 |
Irrigation syringe, bulb or piston, each |
6,505 |
6,123 |
$229K |
| A4244 |
Alcohol or peroxide, per pint |
5,150 |
4,966 |
$180K |
| A4927 |
Gloves, non-sterile, per 100 |
11,203 |
10,850 |
$171K |
| A4554 |
Disposable underpads, all sizes |
6,172 |
5,901 |
$155K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,868 |
1,778 |
$143K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
3,282 |
3,132 |
$139K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
7,883 |
7,423 |
$114K |
| A4245 |
Alcohol wipes, per box |
4,472 |
4,328 |
$107K |
| A7508 |
Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each |
3,325 |
3,168 |
$99K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
2,377 |
2,278 |
$99K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
717 |
562 |
$90K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
2,589 |
2,484 |
$84K |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
7,058 |
6,850 |
$81K |
| A7002 |
Tubing, used with suction pump, each |
7,780 |
7,467 |
$71K |
| A7526 |
Tracheostomy tube collar/holder, each |
4,343 |
4,177 |
$70K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
2,466 |
2,357 |
$70K |
| E0570 |
Nebulizer, with compressor |
875 |
834 |
$68K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
2,345 |
2,222 |
$58K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
7,108 |
6,777 |
$56K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
6,289 |
6,053 |
$55K |
| B9998 |
Noc for enteral supplies |
1,520 |
1,474 |
$42K |
| A7000 |
Canister, disposable, used with suction pump, each |
3,105 |
2,974 |
$37K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
772 |
765 |
$36K |
| A4208 |
Syringe with needle, sterile 3 cc, each |
2,528 |
2,443 |
$29K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
2,439 |
2,296 |
$24K |
| A7015 |
Aerosol mask, used with dme nebulizer |
4,490 |
4,381 |
$21K |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
1,893 |
1,831 |
$19K |
| A4217 |
Sterile water/saline, 500 ml |
1,375 |
1,299 |
$17K |
| 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 |
42 |
38 |
$16K |
| E0601 |
Continuous positive airway pressure (cpap) device |
213 |
212 |
$12K |
| A4332 |
Lubricant, individual sterile packet, each |
1,246 |
1,163 |
$12K |
| E0776 |
Iv pole |
717 |
685 |
$10K |
| A5131 |
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. |
1,736 |
1,638 |
$8K |
| A7525 |
Tracheostomy mask, each |
3,762 |
2,660 |
$8K |
| A6403 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing |
233 |
229 |
$6K |
| A4623 |
Tracheostomy, inner cannula |
309 |
137 |
$6K |
| E0619 |
Apnea monitor, with recording feature |
39 |
38 |
$5K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
65 |
63 |
$2K |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
210 |
196 |
$741.69 |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
51 |
49 |
$719.00 |
| L8501 |
Tracheostomy speaking valve |
13 |
12 |
$512.16 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
13 |
13 |
$6.89 |