| 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 |
67,573 |
66,212 |
$6.42M |
| E0601 |
Continuous positive airway pressure (cpap) device |
22,504 |
22,358 |
$1.32M |
| A7030 |
Full face mask used with positive airway pressure device, each |
10,823 |
10,723 |
$1.13M |
| E0570 |
Nebulizer, with compressor |
41,503 |
41,272 |
$848K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
44,689 |
43,094 |
$763K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
5,379 |
5,360 |
$727K |
| T4541 |
Incontinence product, disposable underpad, large, each |
5,324 |
5,156 |
$655K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,493 |
3,001 |
$631K |
| A7031 |
Face mask interface, replacement for full face mask, each |
11,510 |
11,388 |
$622K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,097 |
4,042 |
$584K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
4,662 |
4,622 |
$582K |
| 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 |
431 |
389 |
$537K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
3,297 |
3,179 |
$482K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
4,296 |
4,200 |
$470K |
| 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 |
1,553 |
1,425 |
$462K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,269 |
3,235 |
$415K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
10,223 |
10,138 |
$411K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
6,449 |
6,403 |
$388K |
| E0202 |
Phototherapy (bilirubin) light with photometer |
6,771 |
1,388 |
$371K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
5,596 |
5,532 |
$353K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,293 |
2,218 |
$347K |
| K0001 |
Standard wheelchair |
14,134 |
13,855 |
$323K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,870 |
1,845 |
$296K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
4,835 |
4,752 |
$288K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,200 |
1,145 |
$276K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,991 |
1,957 |
$265K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
27,038 |
26,659 |
$219K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
4,865 |
4,746 |
$217K |
| A7035 |
Headgear used with positive airway pressure device |
10,326 |
10,161 |
$207K |
| 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 |
1,770 |
1,567 |
$204K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
2,296 |
2,256 |
$197K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,214 |
1,181 |
$186K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,744 |
3,680 |
$173K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
1,475 |
1,470 |
$167K |
| K0003 |
Lightweight wheelchair |
3,994 |
3,947 |
$159K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,304 |
1,288 |
$134K |
| E1392 |
Portable oxygen concentrator, rental |
4,245 |
4,207 |
$133K |
| B9998 |
Noc for enteral supplies |
1,194 |
1,108 |
$109K |
| A7037 |
Tubing used with positive airway pressure device |
5,655 |
5,603 |
$109K |
| 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) |
407 |
388 |
$98K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
448 |
441 |
$91K |
| E1399 |
Durable medical equipment, miscellaneous |
672 |
613 |
$90K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
6,964 |
6,908 |
$84K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
519 |
508 |
$77K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
1,651 |
1,627 |
$74K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
12,806 |
11,736 |
$68K |
| B9002 |
Enteral nutrition infusion pump, any type |
833 |
817 |
$64K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
604 |
587 |
$63K |
| A4927 |
Gloves, non-sterile, per 100 |
6,346 |
6,133 |
$61K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
479 |
463 |
$50K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,193 |
1,169 |
$49K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
667 |
649 |
$47K |
| 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 |
326 |
285 |
$40K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
390 |
380 |
$37K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
529 |
507 |
$37K |
| A4670 |
Automatic blood pressure monitor |
812 |
808 |
$37K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
771 |
769 |
$36K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
267 |
255 |
$34K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
538 |
529 |
$33K |
| E0700 |
Safety equipment, device or accessory, any type |
389 |
385 |
$30K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,798 |
2,563 |
$30K |
| A4452 |
Tape, waterproof, per 18 square inches |
1,336 |
1,266 |
$29K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
297 |
288 |
$28K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
959 |
947 |
$28K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
481 |
476 |
$26K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,338 |
2,313 |
$24K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,293 |
1,235 |
$21K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
83 |
83 |
$19K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
388 |
377 |
$16K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
247 |
198 |
$16K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,100 |
1,059 |
$14K |
| 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 |
40 |
38 |
$13K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,908 |
1,892 |
$13K |
| E0156 |
Seat attachment, walker |
1,014 |
1,002 |
$11K |
| A4322 |
Irrigation syringe, bulb or piston, each |
600 |
573 |
$10K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
144 |
140 |
$9K |
| A7526 |
Tracheostomy tube collar/holder, each |
181 |
169 |
$9K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
129 |
115 |
$8K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
244 |
230 |
$7K |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
5,560 |
5,470 |
$7K |
| A5120 |
Skin barrier, wipes or swabs, each |
893 |
833 |
$7K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
120 |
114 |
$6K |
| A4335 |
Incontinence supply; miscellaneous |
457 |
445 |
$6K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,849 |
2,819 |
$6K |
| A7015 |
Aerosol mask, used with dme nebulizer |
3,916 |
3,858 |
$6K |
| A6242 |
Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
40 |
38 |
$6K |
| A4554 |
Disposable underpads, all sizes |
150 |
146 |
$5K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
51 |
50 |
$4K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
138 |
138 |
$4K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
16 |
14 |
$4K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
252 |
250 |
$3K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
12 |
12 |
$3K |
| A4456 |
Adhesive remover, wipes, any type, each |
291 |
279 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
38 |
38 |
$3K |
| E0776 |
Iv pole |
243 |
242 |
$3K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
53 |
53 |
$3K |
| E0245 |
Tub stool or bench |
65 |
65 |
$2K |
| K0006 |
Heavy duty wheelchair |
27 |
26 |
$2K |
| E0159 |
Brake attachment for wheeled walker, replacement, each |
258 |
255 |
$2K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
217 |
215 |
$1K |
| A4217 |
Sterile water/saline, 500 ml |
51 |
49 |
$1K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
159 |
152 |
$1K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
60 |
60 |
$1K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
117 |
115 |
$949.96 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
241 |
232 |
$709.44 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
27 |
26 |
$708.04 |
| A4629 |
Tracheostomy care kit for established tracheostomy |
12 |
12 |
$684.30 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
12 |
12 |
$618.37 |
| A6445 |
Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard |
25 |
25 |
$613.92 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
76 |
74 |
$543.47 |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
13 |
13 |
$425.63 |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
26 |
25 |
$417.10 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
82 |
79 |
$403.15 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
45 |
40 |
$347.47 |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
25 |
25 |
$300.23 |
| A7036 |
Chinstrap used with positive airway pressure device |
26 |
26 |
$266.02 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
30 |
25 |
$181.00 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
14 |
14 |
$120.29 |
| A7002 |
Tubing, used with suction pump, each |
12 |
12 |
$66.94 |