| 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 |
2,023 |
1,955 |
$268K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,333 |
1,218 |
$237K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
392 |
291 |
$210K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
2,128 |
2,052 |
$138K |
| B9998 |
Noc for enteral supplies |
1,517 |
886 |
$130K |
| 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 |
760 |
712 |
$98K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
713 |
670 |
$73K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
419 |
403 |
$72K |
| A6252 |
Specialty absorptive 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 |
777 |
729 |
$66K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,510 |
1,454 |
$57K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,130 |
1,042 |
$57K |
| B9002 |
Enteral nutrition infusion pump, any type |
880 |
841 |
$54K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
687 |
650 |
$45K |
| A7002 |
Tubing, used with suction pump, each |
1,324 |
1,203 |
$38K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
253 |
185 |
$32K |
| A7508 |
Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each |
711 |
650 |
$30K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
630 |
574 |
$25K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
610 |
458 |
$24K |
| E0776 |
Iv pole |
369 |
361 |
$24K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,224 |
1,118 |
$19K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
832 |
760 |
$15K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
363 |
350 |
$13K |
| A7526 |
Tracheostomy tube collar/holder, each |
934 |
846 |
$12K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,385 |
1,267 |
$8K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
238 |
218 |
$6K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
129 |
127 |
$6K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
201 |
195 |
$5K |
| A7506 |
Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each |
341 |
301 |
$2K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
276 |
175 |
$2K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
184 |
176 |
$1K |
| A4618 |
Breathing circuits |
64 |
62 |
$1K |