| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
5,064 |
2,546 |
$3.42M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,120 |
4,882 |
$702K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
806 |
661 |
$651K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,376 |
1,303 |
$432K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
655 |
607 |
$275K |
| A4217 |
Sterile water/saline, 500 ml |
1,924 |
1,782 |
$249K |
| A4605 |
Tracheal suction catheter, closed system, each |
777 |
670 |
$235K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
3,003 |
2,872 |
$213K |
| A7526 |
Tracheostomy tube collar/holder, each |
2,032 |
1,878 |
$194K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,014 |
958 |
$137K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,363 |
5,110 |
$135K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
2,487 |
2,380 |
$129K |
| A7509 |
Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each |
1,796 |
1,584 |
$127K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
490 |
447 |
$121K |
| A7000 |
Canister, disposable, used with suction pump, each |
2,857 |
2,723 |
$102K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,810 |
1,733 |
$89K |
| A7002 |
Tubing, used with suction pump, each |
3,205 |
3,033 |
$72K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
2,272 |
2,105 |
$68K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
849 |
786 |
$52K |
| K0003 |
Lightweight wheelchair |
600 |
576 |
$45K |
| A4927 |
Gloves, non-sterile, per 100 |
2,420 |
2,323 |
$37K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
654 |
582 |
$36K |
| E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
280 |
261 |
$35K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
2,001 |
1,858 |
$34K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,375 |
1,312 |
$19K |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
862 |
828 |
$15K |
| 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) |
28 |
26 |
$14K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
311 |
289 |
$8K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
441 |
415 |
$7K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
14 |
13 |
$6K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
168 |
160 |
$5K |
| S8189 |
Tracheostomy supply, not otherwise classified |
83 |
76 |
$4K |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
1,103 |
1,047 |
$4K |
| A6211 |
Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
12 |
12 |
$4K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
36 |
36 |
$3K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
234 |
227 |
$2K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
540 |
495 |
$2K |
| E1060 |
Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests |
15 |
12 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
30 |
28 |
$1K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
514 |
475 |
$803.73 |
| A7525 |
Tracheostomy mask, each |
165 |
157 |
$759.65 |
| E0442 |
Stationary oxygen contents, liquid, 1 month's supply = 1 unit |
15 |
12 |
$730.09 |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
12 |
12 |
$708.81 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
70 |
69 |
$684.54 |
| A4452 |
Tape, waterproof, per 18 square inches |
112 |
103 |
$568.94 |
| A4245 |
Alcohol wipes, per box |
215 |
214 |
$529.39 |
| A4332 |
Lubricant, individual sterile packet, each |
267 |
257 |
$380.40 |
| A4649 |
Surgical supply; miscellaneous |
25 |
25 |
$273.86 |
| A4456 |
Adhesive remover, wipes, any type, each |
57 |
54 |
$155.32 |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
170 |
166 |
$146.25 |
| A4618 |
Breathing circuits |
12 |
12 |
$110.24 |
| A5120 |
Skin barrier, wipes or swabs, each |
28 |
25 |
$84.37 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
59 |
52 |
$70.19 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
54 |
53 |
$46.65 |