| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
60,139 |
59,041 |
$10.79M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
22,869 |
22,576 |
$1.37M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
8,684 |
8,531 |
$743K |
| A4927 |
Gloves, non-sterile, per 100 |
23,605 |
23,210 |
$632K |
| T4541 |
Incontinence product, disposable underpad, large, each |
17,588 |
17,159 |
$622K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
5,305 |
5,168 |
$556K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
6,894 |
6,706 |
$516K |
| 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 |
4,769 |
4,609 |
$501K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
11,862 |
11,533 |
$481K |
| K1005 |
Disposable collection and storage bag for breast milk, any size, any type, each |
15,624 |
14,174 |
$434K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
4,031 |
3,972 |
$413K |
| A4287 |
Disposable collection and storage bag for breast milk, any size, any type, each |
9,840 |
7,445 |
$411K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,728 |
2,682 |
$341K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
2,345 |
2,330 |
$330K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
7,123 |
7,018 |
$265K |
| A4670 |
Automatic blood pressure monitor |
4,272 |
4,251 |
$252K |
| E0604 |
Breast pump, hospital grade, electric (ac and / or dc), any type |
3,453 |
3,237 |
$240K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,721 |
2,686 |
$223K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
11,749 |
11,601 |
$185K |
| 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 |
9,462 |
9,338 |
$180K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,007 |
3,976 |
$167K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,626 |
1,615 |
$160K |
| K0001 |
Standard wheelchair |
8,717 |
8,593 |
$148K |
| B4100 |
Food thickener, administered orally, per ounce |
2,189 |
2,022 |
$135K |
| E0570 |
Nebulizer, with compressor |
8,259 |
7,973 |
$129K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,122 |
1,098 |
$113K |
| 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 |
779 |
758 |
$102K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
629 |
610 |
$92K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
448 |
432 |
$91K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
439 |
429 |
$89K |
| 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 |
1,026 |
951 |
$88K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,662 |
2,628 |
$85K |
| E0245 |
Tub stool or bench |
2,099 |
2,070 |
$79K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
2,100 |
2,089 |
$78K |
| A7031 |
Face mask interface, replacement for full face mask, each |
2,062 |
2,048 |
$75K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
6,004 |
5,947 |
$68K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
27,966 |
24,878 |
$67K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
540 |
481 |
$48K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,429 |
1,388 |
$44K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
149 |
149 |
$40K |
| 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) |
357 |
357 |
$37K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,653 |
1,640 |
$36K |
| A4335 |
Incontinence supply; miscellaneous |
3,801 |
3,405 |
$36K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
591 |
586 |
$33K |
| A7035 |
Headgear used with positive airway pressure device |
1,626 |
1,613 |
$32K |
| E1392 |
Portable oxygen concentrator, rental |
2,186 |
2,177 |
$27K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
3,904 |
3,821 |
$27K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,182 |
2,156 |
$25K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
214 |
213 |
$23K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
291 |
267 |
$21K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
557 |
549 |
$20K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
539 |
500 |
$19K |
| A6252 |
Specialty absorptive 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 |
212 |
185 |
$15K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
2,656 |
2,595 |
$14K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
3,122 |
3,103 |
$14K |
| A4282 |
Adapter for breast pump, replacement |
506 |
443 |
$14K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
397 |
395 |
$14K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,717 |
1,605 |
$13K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
461 |
459 |
$13K |
| E1399 |
Durable medical equipment, miscellaneous |
677 |
528 |
$12K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
398 |
343 |
$11K |
| E0244 |
Raised toilet seat |
214 |
207 |
$11K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
290 |
157 |
$11K |
| L2630 |
Addition to lower extremity, pelvic control, band and belt, unilateral |
68 |
65 |
$11K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
714 |
670 |
$10K |
| E0156 |
Seat attachment, walker |
1,524 |
1,499 |
$10K |
| A4281 |
Tubing for breast pump, replacement |
507 |
444 |
$10K |
| E0241 |
Bath tub wall rail, each |
253 |
234 |
$10K |
| A4284 |
Breast shield and splash protector for use with breast pump, replacement |
564 |
446 |
$10K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
808 |
806 |
$9K |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
372 |
346 |
$9K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
791 |
746 |
$9K |
| A4285 |
Polycarbonate bottle for use with breast pump, replacement |
502 |
444 |
$6K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
262 |
157 |
$6K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,003 |
958 |
$6K |
| E0246 |
Transfer tub rail attachment |
102 |
95 |
$6K |
| K0006 |
Heavy duty wheelchair |
82 |
82 |
$5K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
31 |
31 |
$4K |
| A4452 |
Tape, waterproof, per 18 square inches |
444 |
411 |
$4K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
759 |
694 |
$4K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
473 |
449 |
$4K |
| E0315 |
Bed accessory: board, table, or support device, any type |
41 |
37 |
$3K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
483 |
436 |
$3K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
72 |
66 |
$3K |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
64 |
61 |
$3K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
300 |
280 |
$3K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
303 |
298 |
$2K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
53 |
43 |
$2K |
| A7001 |
Canister, non-disposable, used with suction pump, each |
130 |
119 |
$2K |
| E0159 |
Brake attachment for wheeled walker, replacement, each |
301 |
298 |
$1K |
| A4649 |
Surgical supply; miscellaneous |
131 |
127 |
$1K |
| E0277 |
Powered pressure-reducing air mattress |
12 |
12 |
$1K |
| A4217 |
Sterile water/saline, 500 ml |
56 |
52 |
$866.02 |
| A4283 |
Cap for breast pump bottle, replacement |
387 |
351 |
$738.82 |
| A7002 |
Tubing, used with suction pump, each |
345 |
304 |
$617.02 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
255 |
225 |
$597.39 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
33 |
25 |
$447.86 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
145 |
142 |
$323.74 |
| A4311 |
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
43 |
38 |
$321.79 |
| A7000 |
Canister, disposable, used with suction pump, each |
67 |
66 |
$177.67 |
| E0325 |
Urinal; male, jug-type, any material |
32 |
31 |
$142.35 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
13 |
13 |
$31.20 |
| A9270 |
Non-covered item or service |
43 |
29 |
$0.00 |