| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S8189 |
Tracheostomy supply, not otherwise classified |
13,153 |
2,524 |
$1.39M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,420 |
1,978 |
$500K |
| 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 |
1,263 |
1,040 |
$492K |
| B9998 |
Noc for enteral supplies |
4,355 |
2,584 |
$435K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
2,020 |
1,555 |
$398K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,360 |
1,182 |
$149K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
194 |
144 |
$137K |
| A4605 |
Tracheal suction catheter, closed system, each |
330 |
269 |
$129K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,711 |
2,154 |
$111K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
1,160 |
915 |
$103K |
| A4618 |
Breathing circuits |
1,094 |
987 |
$100K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
2,073 |
1,683 |
$65K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
218 |
198 |
$59K |
| A7000 |
Canister, disposable, used with suction pump, each |
3,255 |
2,957 |
$57K |
| A7526 |
Tracheostomy tube collar/holder, each |
2,652 |
2,481 |
$53K |
| E1399 |
Durable medical equipment, miscellaneous |
103 |
94 |
$51K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
4,167 |
2,222 |
$44K |
| A4927 |
Gloves, non-sterile, per 100 |
2,467 |
1,955 |
$40K |
| A7002 |
Tubing, used with suction pump, each |
4,728 |
2,950 |
$39K |
| 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 |
280 |
218 |
$30K |
| S8999 |
Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event) |
252 |
242 |
$25K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,146 |
2,657 |
$20K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
443 |
405 |
$17K |
| A4616 |
Tubing (oxygen), per foot |
496 |
353 |
$16K |
| 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 |
15 |
12 |
$14K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
86 |
75 |
$13K |
| A7037 |
Tubing used with positive airway pressure device |
879 |
829 |
$12K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,618 |
1,505 |
$11K |
| E0601 |
Continuous positive airway pressure (cpap) device |
756 |
741 |
$11K |
| A4623 |
Tracheostomy, inner cannula |
69 |
63 |
$9K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
506 |
457 |
$7K |
| L8501 |
Tracheostomy speaking valve |
92 |
87 |
$7K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
98 |
91 |
$6K |
| A7525 |
Tracheostomy mask, each |
1,201 |
1,002 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,087 |
1,004 |
$4K |
| K0001 |
Standard wheelchair |
445 |
430 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
302 |
294 |
$2K |
| 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 |
14 |
12 |
$2K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
278 |
225 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
27 |
24 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
316 |
275 |
$2K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
16 |
16 |
$2K |
| A7012 |
Water collection device, used with large volume nebulizer |
243 |
207 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
28 |
28 |
$686.37 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
114 |
114 |
$216.31 |
| T2028 |
Specialized supply, not otherwise specified, waiver |
20 |
20 |
$0.00 |
| T4541 |
Incontinence product, disposable underpad, large, each |
36 |
36 |
$0.00 |