| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
3,810 |
3,677 |
$4.87M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
25,160 |
24,199 |
$2.50M |
| B9998 |
Noc for enteral supplies |
33,161 |
30,286 |
$1.71M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
13,192 |
11,926 |
$1.55M |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
3,385 |
3,165 |
$1.19M |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,629 |
1,507 |
$784K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
6,658 |
6,413 |
$760K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
3,415 |
3,260 |
$583K |
| S8189 |
Tracheostomy supply, not otherwise classified |
12,501 |
7,847 |
$484K |
| A7526 |
Tracheostomy tube collar/holder, each |
6,195 |
5,981 |
$471K |
| 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 |
4,551 |
4,320 |
$457K |
| T5999 |
Supply, not otherwise specified |
7,586 |
3,359 |
$419K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
4,356 |
4,101 |
$408K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
2,410 |
2,358 |
$400K |
| B9002 |
Enteral nutrition infusion pump, any type |
3,783 |
3,622 |
$394K |
| 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 |
9,522 |
8,951 |
$379K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
14,661 |
8,952 |
$340K |
| A4223 |
Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) |
11,599 |
1,579 |
$313K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
14,974 |
13,547 |
$303K |
| A7509 |
Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each |
1,666 |
1,599 |
$214K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
29,165 |
26,857 |
$200K |
| A4322 |
Irrigation syringe, bulb or piston, each |
28,672 |
27,643 |
$199K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
4,382 |
3,257 |
$182K |
| 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) |
406 |
345 |
$177K |
| L8501 |
Tracheostomy speaking valve |
1,904 |
1,857 |
$149K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
7,247 |
7,015 |
$146K |
| A7000 |
Canister, disposable, used with suction pump, each |
13,084 |
12,631 |
$142K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
9,325 |
9,097 |
$139K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
7,537 |
5,719 |
$119K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,073 |
1,846 |
$110K |
| B9999 |
Noc for parenteral supplies |
3,594 |
790 |
$103K |
| 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 |
1,466 |
1,355 |
$102K |
| A4927 |
Gloves, non-sterile, per 100 |
5,149 |
4,571 |
$57K |
| A4930 |
Gloves, sterile, per pair |
3,937 |
1,803 |
$52K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
3,403 |
3,327 |
$47K |
| 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 |
1,300 |
1,237 |
$46K |
| A4215 |
Needle, sterile, any size, each |
2,148 |
2,077 |
$42K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,027 |
1,705 |
$38K |
| A4657 |
Syringe, with or without needle, each |
14,554 |
10,912 |
$36K |
| A7002 |
Tubing, used with suction pump, each |
9,005 |
8,814 |
$31K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
78 |
76 |
$27K |
| 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 |
1,542 |
1,421 |
$19K |
| E0570 |
Nebulizer, with compressor |
513 |
507 |
$17K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
10,123 |
9,946 |
$16K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
3,447 |
2,819 |
$16K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
760 |
429 |
$15K |
| A4212 |
Non-coring needle or stylet with or without catheter |
481 |
358 |
$15K |
| A7015 |
Aerosol mask, used with dme nebulizer |
7,157 |
6,964 |
$11K |
| E0781 |
Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient |
58 |
49 |
$11K |
| A4248 |
Chlorhexidine containing antiseptic, 1 ml |
2,701 |
1,285 |
$10K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
134 |
134 |
$9K |
| B4081 |
Nasogastric tubing with stylet |
169 |
164 |
$7K |
| A6442 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard |
3,410 |
3,321 |
$7K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
12 |
12 |
$6K |
| J7131 |
Hypertonic saline solution, 1 ml |
232 |
224 |
$5K |
| A4245 |
Alcohol wipes, per box |
4,046 |
3,811 |
$4K |
| S1015 |
Iv tubing extension set |
271 |
87 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
179 |
174 |
$1K |
| A4421 |
Ostomy supply; miscellaneous |
288 |
275 |
$937.83 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
154 |
154 |
$682.39 |