| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
6,275 |
4,192 |
$5.28M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
9,847 |
8,021 |
$2.41M |
| 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 |
4,738 |
3,537 |
$1.78M |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
10,402 |
8,610 |
$1.54M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
12,154 |
10,057 |
$1.41M |
| 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 |
2,960 |
2,177 |
$921K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,389 |
1,007 |
$850K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
3,400 |
2,703 |
$699K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
2,157 |
1,738 |
$553K |
| E1399 |
Durable medical equipment, miscellaneous |
4,527 |
2,235 |
$487K |
| B9002 |
Enteral nutrition infusion pump, any type |
4,990 |
4,251 |
$467K |
| 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 |
3,782 |
3,059 |
$422K |
| A4217 |
Sterile water/saline, 500 ml |
5,255 |
3,683 |
$360K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
2,890 |
2,159 |
$353K |
| A7526 |
Tracheostomy tube collar/holder, each |
5,944 |
4,731 |
$263K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,570 |
9,828 |
$261K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
3,143 |
2,010 |
$239K |
| B9998 |
Noc for enteral supplies |
2,887 |
1,787 |
$227K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
1,383 |
1,225 |
$205K |
| S8189 |
Tracheostomy supply, not otherwise classified |
1,035 |
505 |
$186K |
| E0619 |
Apnea monitor, with recording feature |
901 |
795 |
$162K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
2,465 |
2,039 |
$160K |
| A7000 |
Canister, disposable, used with suction pump, each |
6,130 |
4,901 |
$148K |
| 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 |
1,611 |
1,250 |
$122K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
1,174 |
922 |
$76K |
| A4605 |
Tracheal suction catheter, closed system, each |
1,139 |
812 |
$74K |
| L8501 |
Tracheostomy speaking valve |
654 |
517 |
$70K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
629 |
351 |
$58K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
4,160 |
3,283 |
$47K |
| 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 |
351 |
282 |
$30K |
| E0601 |
Continuous positive airway pressure (cpap) device |
555 |
453 |
$29K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
403 |
327 |
$28K |
| A7002 |
Tubing, used with suction pump, each |
6,017 |
4,757 |
$28K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
145 |
98 |
$25K |
| A4927 |
Gloves, non-sterile, per 100 |
2,318 |
1,782 |
$23K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
81 |
64 |
$22K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
1,767 |
1,147 |
$16K |
| E0776 |
Iv pole |
269 |
241 |
$14K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
1,480 |
1,197 |
$11K |
| A7525 |
Tracheostomy mask, each |
2,827 |
2,028 |
$10K |
| A7012 |
Water collection device, used with large volume nebulizer |
1,391 |
1,177 |
$10K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,772 |
3,032 |
$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 |
38 |
26 |
$6K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
429 |
261 |
$5K |
| A4402 |
Lubricant, per ounce |
1,145 |
894 |
$5K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
208 |
181 |
$3K |
| A4244 |
Alcohol or peroxide, per pint |
2,268 |
1,823 |
$2K |
| A4245 |
Alcohol wipes, per box |
507 |
425 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
14 |
12 |
$336.42 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
92 |
66 |
$324.99 |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
296 |
246 |
$247.12 |
| A7015 |
Aerosol mask, used with dme nebulizer |
26 |
24 |
$31.92 |