| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
10,048 |
9,463 |
$7.93M |
| 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 |
9,375 |
9,153 |
$6.79M |
| B9998 |
Noc for enteral supplies |
34,233 |
22,900 |
$6.07M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
19,823 |
19,434 |
$5.43M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
32,368 |
32,058 |
$3.71M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
4,696 |
4,662 |
$3.50M |
| E1399 |
Durable medical equipment, miscellaneous |
8,463 |
5,721 |
$2.79M |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
10,380 |
10,303 |
$2.65M |
| 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 |
8,368 |
8,119 |
$2.41M |
| E0481 |
Intrapulmonary percussive ventilation system and related accessories |
2,592 |
2,473 |
$2.17M |
| 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 |
6,032 |
5,412 |
$2.06M |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
10,585 |
10,234 |
$1.60M |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
14,598 |
12,697 |
$1.52M |
| 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 |
1,007 |
988 |
$1.31M |
| 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 |
3,664 |
3,505 |
$1.01M |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
8,198 |
7,830 |
$903K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
7,747 |
7,627 |
$785K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
4,922 |
4,840 |
$728K |
| A4605 |
Tracheal suction catheter, closed system, each |
4,663 |
4,404 |
$671K |
| B9002 |
Enteral nutrition infusion pump, any type |
4,684 |
4,583 |
$653K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
31,205 |
30,719 |
$624K |
| A7000 |
Canister, disposable, used with suction pump, each |
16,829 |
16,445 |
$578K |
| 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) |
1,707 |
1,687 |
$572K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
3,706 |
3,328 |
$554K |
| A4554 |
Disposable underpads, all sizes |
17,174 |
16,803 |
$544K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
677 |
623 |
$450K |
| B4104 |
Additive for enteral formula (e.g., fiber) |
2,425 |
2,328 |
$364K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
3,422 |
3,339 |
$360K |
| A7526 |
Tracheostomy tube collar/holder, each |
10,351 |
9,438 |
$349K |
| A4322 |
Irrigation syringe, bulb or piston, each |
21,485 |
20,570 |
$339K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
2,940 |
2,882 |
$307K |
| 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 |
1,036 |
1,019 |
$304K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
27,014 |
17,205 |
$291K |
| A7002 |
Tubing, used with suction pump, each |
17,233 |
16,901 |
$290K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
4,930 |
4,817 |
$287K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
2,367 |
2,309 |
$279K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
2,648 |
2,583 |
$264K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
22,638 |
19,645 |
$218K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
855 |
780 |
$216K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
2,165 |
2,021 |
$207K |
| A6210 |
Foam 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 |
830 |
649 |
$201K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
8,775 |
7,580 |
$199K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,789 |
2,735 |
$187K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,587 |
1,535 |
$186K |
| 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 |
209 |
205 |
$169K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
2,823 |
2,748 |
$164K |
| 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 |
352 |
347 |
$122K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
4,776 |
4,560 |
$120K |
| 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 |
535 |
525 |
$115K |
| A4335 |
Incontinence supply; miscellaneous |
22,389 |
21,832 |
$114K |
| 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) |
548 |
546 |
$103K |
| B4103 |
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
1,565 |
1,532 |
$103K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
18,377 |
17,307 |
$98K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
404 |
395 |
$96K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
6,232 |
6,131 |
$94K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
450 |
409 |
$89K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
5,900 |
5,190 |
$88K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
755 |
690 |
$86K |
| E0570 |
Nebulizer, with compressor |
948 |
935 |
$78K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
20,672 |
20,310 |
$71K |
| A4452 |
Tape, waterproof, per 18 square inches |
12,758 |
12,281 |
$64K |
| A4927 |
Gloves, non-sterile, per 100 |
8,081 |
7,781 |
$57K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
1,455 |
1,365 |
$48K |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
4,217 |
4,112 |
$39K |
| A4217 |
Sterile water/saline, 500 ml |
552 |
441 |
$32K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
297 |
293 |
$32K |
| A4402 |
Lubricant, per ounce |
6,356 |
6,252 |
$31K |
| E0776 |
Iv pole |
3,276 |
3,215 |
$31K |
| B4100 |
Food thickener, administered orally, per ounce |
194 |
191 |
$24K |
| A4481 |
Tracheostoma filter, any type, any size, each |
2,889 |
2,642 |
$24K |
| L8501 |
Tracheostomy speaking valve |
452 |
440 |
$23K |
| A7012 |
Water collection device, used with large volume nebulizer |
5,157 |
4,672 |
$22K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
2,544 |
2,444 |
$22K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
569 |
561 |
$22K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,712 |
1,399 |
$21K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
320 |
302 |
$18K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
843 |
824 |
$18K |
| A7030 |
Full face mask used with positive airway pressure device, each |
190 |
185 |
$17K |
| A7525 |
Tracheostomy mask, each |
4,499 |
4,410 |
$17K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
124 |
122 |
$15K |
| A7037 |
Tubing used with positive airway pressure device |
1,047 |
913 |
$15K |
| A7015 |
Aerosol mask, used with dme nebulizer |
12,183 |
11,921 |
$15K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
4,233 |
4,093 |
$11K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,614 |
2,193 |
$10K |
| A4657 |
Syringe, with or without needle, each |
2,016 |
1,799 |
$9K |
| S8999 |
Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event) |
56 |
54 |
$6K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
867 |
843 |
$5K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
1,482 |
1,420 |
$4K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
818 |
804 |
$4K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
103 |
101 |
$3K |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
193 |
170 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
157 |
155 |
$2K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
208 |
206 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
37 |
37 |
$2K |
| A4332 |
Lubricant, individual sterile packet, each |
775 |
773 |
$2K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
114 |
113 |
$1K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
66 |
51 |
$1K |
| A5120 |
Skin barrier, wipes or swabs, each |
179 |
162 |
$1K |
| A4244 |
Alcohol or peroxide, per pint |
490 |
487 |
$691.35 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
374 |
370 |
$658.75 |
| A4618 |
Breathing circuits |
246 |
229 |
$586.38 |
| A4615 |
Cannula, nasal |
1,133 |
1,011 |
$513.27 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
116 |
109 |
$484.92 |
| A4245 |
Alcohol wipes, per box |
316 |
314 |
$426.64 |
| A4616 |
Tubing (oxygen), per foot |
1,828 |
1,379 |
$413.29 |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
14 |
12 |
$360.50 |
| S8101 |
Holding chamber or spacer for use with an inhaler or nebulizer; with mask |
12 |
12 |
$274.60 |
| A4371 |
Ostomy skin barrier, powder, per oz |
27 |
26 |
$91.54 |
| A4649 |
Surgical supply; miscellaneous |
14 |
13 |
$0.00 |