| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
19,939 |
18,438 |
$15.26M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
53,254 |
50,681 |
$14.17M |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
18,464 |
15,510 |
$12.83M |
| B9998 |
Noc for enteral supplies |
74,657 |
58,262 |
$6.60M |
| 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 |
20,841 |
19,533 |
$6.42M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
47,443 |
46,737 |
$5.51M |
| 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 |
12,444 |
11,350 |
$4.91M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
6,389 |
6,080 |
$4.84M |
| 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 |
3,325 |
3,079 |
$4.81M |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
51,005 |
31,648 |
$3.71M |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
11,636 |
11,435 |
$3.00M |
| 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 |
10,257 |
9,568 |
$2.89M |
| E1399 |
Durable medical equipment, miscellaneous |
6,107 |
5,516 |
$2.67M |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
16,489 |
15,640 |
$2.32M |
| A4605 |
Tracheal suction catheter, closed system, each |
10,114 |
9,253 |
$2.24M |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
2,611 |
2,369 |
$1.73M |
| 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 |
5,610 |
5,176 |
$1.61M |
| A7000 |
Canister, disposable, used with suction pump, each |
36,161 |
34,855 |
$1.51M |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
11,755 |
10,868 |
$1.51M |
| A4554 |
Disposable underpads, all sizes |
43,776 |
42,203 |
$1.28M |
| A4629 |
Tracheostomy care kit for established tracheostomy |
14,591 |
13,893 |
$1.25M |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
8,170 |
7,947 |
$1.19M |
| B9002 |
Enteral nutrition infusion pump, any type |
13,659 |
13,358 |
$1.10M |
| 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 |
2,894 |
2,714 |
$1.09M |
| 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 |
4,043 |
3,872 |
$1.01M |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
12,503 |
11,397 |
$994K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
7,530 |
6,867 |
$988K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
7,611 |
6,832 |
$965K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
47,595 |
46,940 |
$953K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
8,737 |
8,460 |
$893K |
| 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 |
3,551 |
3,300 |
$802K |
| A7526 |
Tracheostomy tube collar/holder, each |
20,932 |
19,379 |
$786K |
| 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 |
1,269 |
1,123 |
$767K |
| B4103 |
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
4,105 |
3,894 |
$680K |
| 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) |
1,963 |
1,922 |
$637K |
| A7002 |
Tubing, used with suction pump, each |
35,954 |
34,581 |
$623K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
6,853 |
6,490 |
$605K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
5,547 |
5,400 |
$593K |
| E0481 |
Intrapulmonary percussive ventilation system and related accessories |
1,002 |
992 |
$556K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
5,074 |
4,855 |
$501K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
4,276 |
4,142 |
$456K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
4,950 |
4,769 |
$439K |
| B4104 |
Additive for enteral formula (e.g., fiber) |
4,735 |
4,473 |
$404K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
3,381 |
3,296 |
$394K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,120 |
3,023 |
$341K |
| A4335 |
Incontinence supply; miscellaneous |
57,855 |
55,468 |
$285K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,799 |
1,541 |
$276K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,690 |
1,636 |
$255K |
| A4927 |
Gloves, non-sterile, per 100 |
37,284 |
35,963 |
$255K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,481 |
1,344 |
$255K |
| A4322 |
Irrigation syringe, bulb or piston, each |
18,052 |
17,306 |
$219K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,621 |
1,557 |
$201K |
| E0601 |
Continuous positive airway pressure (cpap) device |
3,012 |
2,985 |
$196K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
44,223 |
41,371 |
$196K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
969 |
895 |
$194K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
31,871 |
30,556 |
$181K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
3,676 |
3,493 |
$179K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
5,449 |
5,233 |
$141K |
| A4217 |
Sterile water/saline, 500 ml |
2,883 |
2,648 |
$103K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
31,970 |
30,968 |
$101K |
| E0776 |
Iv pole |
12,167 |
11,946 |
$85K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
609 |
601 |
$82K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
4,794 |
4,729 |
$82K |
| A4402 |
Lubricant, per ounce |
18,077 |
17,425 |
$80K |
| A4623 |
Tracheostomy, inner cannula |
1,803 |
1,573 |
$77K |
| E0570 |
Nebulizer, with compressor |
1,196 |
1,169 |
$77K |
| A4481 |
Tracheostoma filter, any type, any size, each |
6,768 |
6,192 |
$73K |
| 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) |
426 |
421 |
$72K |
| B4100 |
Food thickener, administered orally, per ounce |
2,503 |
2,415 |
$61K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
3,368 |
3,171 |
$56K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
459 |
428 |
$56K |
| K0003 |
Lightweight wheelchair |
947 |
917 |
$49K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
1,424 |
1,399 |
$42K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
19,015 |
18,524 |
$39K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
497 |
488 |
$38K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
3,390 |
3,235 |
$36K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
640 |
578 |
$27K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
248 |
219 |
$26K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
5,574 |
5,308 |
$25K |
| A7012 |
Water collection device, used with large volume nebulizer |
5,920 |
5,640 |
$25K |
| A7525 |
Tracheostomy mask, each |
10,453 |
7,019 |
$24K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
4,985 |
4,729 |
$24K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,413 |
1,323 |
$21K |
| A7015 |
Aerosol mask, used with dme nebulizer |
15,675 |
15,352 |
$17K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
1,167 |
1,144 |
$16K |
| E0619 |
Apnea monitor, with recording feature |
94 |
91 |
$14K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
852 |
798 |
$14K |
| A4452 |
Tape, waterproof, per 18 square inches |
945 |
889 |
$13K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,228 |
1,179 |
$11K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
166 |
156 |
$11K |
| A6260 |
Wound cleansers, any type, any size |
1,005 |
974 |
$9K |
| A4456 |
Adhesive remover, wipes, any type, each |
945 |
903 |
$9K |
| A4371 |
Ostomy skin barrier, powder, per oz |
1,842 |
1,803 |
$8K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
56 |
53 |
$7K |
| B4081 |
Nasogastric tubing with stylet |
98 |
90 |
$7K |
| B4082 |
Nasogastric tubing without stylet |
147 |
131 |
$7K |
| A5120 |
Skin barrier, wipes or swabs, each |
713 |
675 |
$7K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
85 |
75 |
$6K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
496 |
450 |
$6K |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
1,824 |
1,786 |
$5K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
101 |
101 |
$5K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
174 |
163 |
$4K |
| A5200 |
Percutaneous catheter/tube anchoring device, adhesive skin attachment |
98 |
85 |
$4K |
| A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
507 |
482 |
$4K |
| A4259 |
Lancets, per box of 100 |
536 |
527 |
$3K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
158 |
154 |
$3K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
67 |
65 |
$3K |
| S8999 |
Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event) |
28 |
28 |
$3K |
| A4245 |
Alcohol wipes, per box |
1,249 |
1,203 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
301 |
292 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
84 |
81 |
$1K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
25 |
25 |
$961.32 |
| L8501 |
Tracheostomy speaking valve |
13 |
12 |
$807.50 |
| A7037 |
Tubing used with positive airway pressure device |
27 |
24 |
$487.22 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
28 |
25 |
$312.90 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
368 |
328 |
$133.01 |