| 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 |
31,078 |
23,522 |
$7.77M |
| 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 |
8,593 |
7,141 |
$5.42M |
| 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 |
7,332 |
6,149 |
$2.89M |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
16,820 |
16,409 |
$2.60M |
| 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 |
17,316 |
14,271 |
$2.50M |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
2,233 |
1,391 |
$2.00M |
| B9002 |
Enteral nutrition infusion pump, any type |
11,197 |
10,526 |
$1.30M |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
2,184 |
1,447 |
$943K |
| B4100 |
Food thickener, administered orally, per ounce |
7,014 |
6,449 |
$893K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
693 |
606 |
$659K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
5,168 |
5,090 |
$492K |
| 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 |
1,440 |
1,233 |
$455K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,010 |
2,654 |
$422K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,019 |
2,870 |
$399K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,660 |
1,484 |
$338K |
| 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 |
2,460 |
2,098 |
$276K |
| 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 |
3,125 |
2,582 |
$222K |
| 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 |
1,415 |
1,235 |
$198K |
| A4217 |
Sterile water/saline, 500 ml |
1,058 |
1,001 |
$159K |
| B4082 |
Nasogastric tubing without stylet |
3,536 |
3,356 |
$159K |
| A4605 |
Tracheal suction catheter, closed system, each |
529 |
500 |
$158K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
283 |
270 |
$152K |
| 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 |
1,737 |
1,510 |
$138K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
589 |
555 |
$136K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
1,976 |
1,361 |
$135K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
1,572 |
1,506 |
$130K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
467 |
454 |
$126K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,000 |
962 |
$121K |
| B4103 |
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
1,622 |
1,333 |
$111K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,710 |
1,628 |
$106K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,044 |
2,887 |
$90K |
| A7509 |
Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each |
854 |
803 |
$70K |
| B4189 |
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix |
16 |
12 |
$59K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
452 |
421 |
$54K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,693 |
1,654 |
$52K |
| B4224 |
Parenteral nutrition administration kit, per day |
96 |
62 |
$48K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,024 |
971 |
$47K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
1,322 |
1,213 |
$42K |
| 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 |
60 |
52 |
$41K |
| A7002 |
Tubing, used with suction pump, each |
1,764 |
1,724 |
$36K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
28 |
28 |
$25K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
377 |
357 |
$25K |
| 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) |
46 |
40 |
$22K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
65 |
62 |
$19K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,125 |
1,102 |
$19K |
| A4927 |
Gloves, non-sterile, per 100 |
1,125 |
1,093 |
$19K |
| B4185 |
Parenteral nutrition solution, not otherwise specified, 10 grams lipids |
34 |
24 |
$15K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
223 |
219 |
$13K |
| B4220 |
Parenteral nutrition supply kit; premix, per day |
79 |
50 |
$12K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
253 |
246 |
$7K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
49 |
45 |
$6K |
| S9342 |
Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
66 |
63 |
$6K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
1,267 |
1,190 |
$5K |
| J3490 |
Unclassified drugs |
264 |
175 |
$4K |
| B4162 |
Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
12 |
12 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
216 |
211 |
$4K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
32 |
31 |
$3K |
| S8189 |
Tracheostomy supply, not otherwise classified |
67 |
61 |
$3K |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
731 |
710 |
$3K |
| A4452 |
Tape, waterproof, per 18 square inches |
443 |
425 |
$2K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
314 |
306 |
$1K |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
74 |
74 |
$1K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
81 |
77 |
$711.19 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
51 |
51 |
$486.89 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
288 |
284 |
$444.01 |
| A7015 |
Aerosol mask, used with dme nebulizer |
29 |
28 |
$60.88 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
42 |
42 |
$55.34 |