| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
2,536 |
2,277 |
$1.69M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,765 |
1,715 |
$1.28M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
11,260 |
11,127 |
$1.12M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
4,862 |
4,659 |
$1.02M |
| 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 |
1,474 |
1,418 |
$974K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
3,043 |
3,012 |
$675K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
27,000 |
6,625 |
$663K |
| B9998 |
Noc for enteral supplies |
8,167 |
6,246 |
$578K |
| 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 |
2,107 |
2,037 |
$532K |
| 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 |
1,270 |
1,185 |
$354K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,129 |
1,096 |
$279K |
| 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 |
1,378 |
1,105 |
$226K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,802 |
1,706 |
$226K |
| 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) |
734 |
727 |
$203K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,631 |
11,508 |
$198K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,692 |
1,627 |
$173K |
| E1399 |
Durable medical equipment, miscellaneous |
1,071 |
839 |
$155K |
| A4605 |
Tracheal suction catheter, closed system, each |
1,240 |
1,021 |
$147K |
| 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 |
1,010 |
954 |
$142K |
| A7000 |
Canister, disposable, used with suction pump, each |
6,162 |
5,816 |
$134K |
| 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 |
452 |
420 |
$126K |
| A7526 |
Tracheostomy tube collar/holder, each |
3,425 |
2,572 |
$97K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
12,719 |
5,669 |
$94K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
1,152 |
740 |
$79K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
1,147 |
1,117 |
$71K |
| A4554 |
Disposable underpads, all sizes |
2,328 |
2,265 |
$60K |
| A7002 |
Tubing, used with suction pump, each |
6,045 |
5,921 |
$54K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
2,603 |
2,215 |
$47K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
627 |
578 |
$47K |
| B9002 |
Enteral nutrition infusion pump, any type |
272 |
264 |
$42K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
2,396 |
2,120 |
$41K |
| A4322 |
Irrigation syringe, bulb or piston, each |
4,791 |
4,620 |
$32K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
11,864 |
5,896 |
$29K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
247 |
243 |
$23K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
7,335 |
7,196 |
$20K |
| E0601 |
Continuous positive airway pressure (cpap) device |
389 |
384 |
$19K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
5,216 |
4,468 |
$16K |
| A4335 |
Incontinence supply; miscellaneous |
3,783 |
3,502 |
$15K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
993 |
979 |
$12K |
| A4927 |
Gloves, non-sterile, per 100 |
1,906 |
1,766 |
$10K |
| B4103 |
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
83 |
76 |
$9K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
62 |
62 |
$9K |
| A4402 |
Lubricant, per ounce |
1,630 |
1,532 |
$7K |
| A7015 |
Aerosol mask, used with dme nebulizer |
5,037 |
4,973 |
$5K |
| B4104 |
Additive for enteral formula (e.g., fiber) |
39 |
39 |
$3K |
| E0570 |
Nebulizer, with compressor |
39 |
38 |
$3K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
2,085 |
2,001 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
971 |
903 |
$2K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
1,206 |
1,097 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
95 |
93 |
$1K |
| A7525 |
Tracheostomy mask, each |
778 |
326 |
$975.94 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
1,416 |
1,324 |
$597.56 |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
312 |
297 |
$223.30 |
| A5055 |
Stoma cap |
12 |
12 |
$17.03 |