| 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 |
62,417 |
61,296 |
$5.57M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
46,426 |
44,664 |
$744K |
| E0601 |
Continuous positive airway pressure (cpap) device |
8,779 |
8,689 |
$476K |
| A7030 |
Full face mask used with positive airway pressure device, each |
4,510 |
4,412 |
$422K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,342 |
1,997 |
$415K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
3,586 |
3,528 |
$397K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
2,112 |
2,086 |
$266K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,409 |
2,329 |
$251K |
| 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) |
2,196 |
2,136 |
$238K |
| A7031 |
Face mask interface, replacement for full face mask, each |
4,222 |
4,143 |
$226K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,642 |
1,606 |
$171K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,115 |
1,104 |
$154K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,704 |
2,671 |
$144K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
943 |
918 |
$129K |
| E0570 |
Nebulizer, with compressor |
5,345 |
5,258 |
$128K |
| E1392 |
Portable oxygen concentrator, rental |
4,515 |
4,460 |
$127K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,045 |
1,034 |
$124K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,118 |
3,074 |
$115K |
| K0001 |
Standard wheelchair |
5,399 |
5,282 |
$106K |
| B9998 |
Noc for enteral supplies |
732 |
601 |
$102K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
717 |
702 |
$100K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
1,592 |
1,564 |
$96K |
| K0003 |
Lightweight wheelchair |
2,415 |
2,356 |
$82K |
| 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 |
185 |
180 |
$73K |
| A7035 |
Headgear used with positive airway pressure device |
3,944 |
3,827 |
$72K |
| 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) |
281 |
276 |
$71K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
8,341 |
8,183 |
$71K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,931 |
1,905 |
$69K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
320 |
311 |
$52K |
| A7037 |
Tubing used with positive airway pressure device |
2,819 |
2,776 |
$49K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,184 |
1,165 |
$47K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
309 |
299 |
$45K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
699 |
691 |
$44K |
| B9002 |
Enteral nutrition infusion pump, any type |
545 |
528 |
$43K |
| A4927 |
Gloves, non-sterile, per 100 |
3,396 |
3,191 |
$35K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
6,403 |
5,779 |
$35K |
| A4452 |
Tape, waterproof, per 18 square inches |
1,144 |
1,095 |
$32K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
2,626 |
2,586 |
$30K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
1,426 |
1,372 |
$26K |
| E0202 |
Phototherapy (bilirubin) light with photometer |
510 |
118 |
$25K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
412 |
410 |
$17K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
116 |
116 |
$16K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
193 |
183 |
$13K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
95 |
89 |
$12K |
| E0604 |
Breast pump, hospital grade, electric (ac and / or dc), any type |
173 |
173 |
$11K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
69 |
68 |
$11K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,062 |
1,052 |
$10K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
69 |
66 |
$9K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,005 |
897 |
$9K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
106 |
102 |
$9K |
| 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 |
74 |
63 |
$8K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
14 |
14 |
$6K |
| A4322 |
Irrigation syringe, bulb or piston, each |
244 |
208 |
$5K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
211 |
205 |
$5K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
14 |
12 |
$5K |
| E1399 |
Durable medical equipment, miscellaneous |
32 |
27 |
$4K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
50 |
49 |
$4K |
| A4554 |
Disposable underpads, all sizes |
44 |
42 |
$2K |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
1,311 |
1,286 |
$2K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
69 |
66 |
$1K |
| A6260 |
Wound cleansers, any type, any size |
103 |
98 |
$1K |
| A7000 |
Canister, disposable, used with suction pump, each |
91 |
82 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
409 |
400 |
$823.96 |
| A4335 |
Incontinence supply; miscellaneous |
50 |
50 |
$705.85 |
| A5120 |
Skin barrier, wipes or swabs, each |
66 |
63 |
$637.21 |
| A7015 |
Aerosol mask, used with dme nebulizer |
301 |
294 |
$433.33 |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
15 |
12 |
$281.06 |
| E0156 |
Seat attachment, walker |
27 |
26 |
$248.59 |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
15 |
12 |
$245.09 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
14 |
12 |
$244.28 |
| E0776 |
Iv pole |
14 |
13 |
$242.31 |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
17 |
13 |
$113.86 |
| A4371 |
Ostomy skin barrier, powder, per oz |
12 |
12 |
$36.63 |