| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,983 |
1,517 |
$738K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
7,337 |
6,694 |
$469K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,297 |
4,479 |
$457K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
2,966 |
2,911 |
$371K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,410 |
1,199 |
$297K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,286 |
1,247 |
$264K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
2,011 |
1,987 |
$155K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,395 |
1,360 |
$147K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,454 |
1,408 |
$133K |
| A4554 |
Disposable underpads, all sizes |
4,179 |
4,074 |
$130K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,770 |
1,707 |
$118K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
1,115 |
1,068 |
$116K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,177 |
1,140 |
$98K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,113 |
1,885 |
$80K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,706 |
2,019 |
$64K |
| B9998 |
Noc for enteral supplies |
1,702 |
1,610 |
$62K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,683 |
2,227 |
$62K |
| A4927 |
Gloves, non-sterile, per 100 |
6,648 |
6,276 |
$60K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
525 |
522 |
$58K |
| 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 |
290 |
280 |
$56K |
| A7508 |
Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each |
1,128 |
980 |
$47K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
759 |
644 |
$44K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
299 |
293 |
$36K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
345 |
336 |
$36K |
| E1399 |
Durable medical equipment, miscellaneous |
17 |
15 |
$36K |
| 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 |
105 |
96 |
$34K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
208 |
184 |
$33K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,487 |
1,384 |
$33K |
| K0001 |
Standard wheelchair |
3,651 |
2,835 |
$27K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
1,076 |
985 |
$26K |
| 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 |
48 |
48 |
$25K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
505 |
447 |
$24K |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
1,324 |
1,271 |
$24K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
394 |
307 |
$23K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,845 |
1,606 |
$23K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
234 |
224 |
$22K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
843 |
731 |
$19K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
716 |
544 |
$19K |
| A7002 |
Tubing, used with suction pump, each |
2,935 |
2,622 |
$16K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
957 |
838 |
$12K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,431 |
1,343 |
$11K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
139 |
109 |
$10K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,530 |
1,959 |
$9K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,628 |
1,409 |
$9K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
48 |
48 |
$7K |
| E0570 |
Nebulizer, with compressor |
526 |
455 |
$7K |
| E1392 |
Portable oxygen concentrator, rental |
333 |
291 |
$4K |
| A4605 |
Tracheal suction catheter, closed system, each |
348 |
291 |
$3K |
| A4623 |
Tracheostomy, inner cannula |
154 |
125 |
$3K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
919 |
382 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
492 |
403 |
$2K |
| K0003 |
Lightweight wheelchair |
163 |
128 |
$2K |
| A4402 |
Lubricant, per ounce |
423 |
366 |
$1K |
| A7015 |
Aerosol mask, used with dme nebulizer |
846 |
804 |
$1K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
52 |
50 |
$761.56 |
| A7525 |
Tracheostomy mask, each |
331 |
248 |
$745.97 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
14 |
13 |
$683.26 |
| A7030 |
Full face mask used with positive airway pressure device, each |
14 |
12 |
$612.42 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
217 |
198 |
$456.18 |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
62 |
53 |
$350.57 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
161 |
106 |
$209.56 |
| A7035 |
Headgear used with positive airway pressure device |
14 |
12 |
$166.21 |
| A7012 |
Water collection device, used with large volume nebulizer |
44 |
39 |
$95.68 |
| A4244 |
Alcohol or peroxide, per pint |
38 |
36 |
$89.25 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
35 |
24 |
$77.60 |
| A7037 |
Tubing used with positive airway pressure device |
29 |
25 |
$57.88 |