| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
5,409 |
4,196 |
$2.37M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,866 |
1,687 |
$1.08M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
4,038 |
3,615 |
$965K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
5,001 |
4,358 |
$645K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
4,336 |
3,420 |
$556K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
1,682 |
1,454 |
$486K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
3,539 |
3,141 |
$408K |
| A4605 |
Tracheal suction catheter, closed system, each |
2,582 |
2,356 |
$401K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
4,781 |
4,078 |
$389K |
| A7526 |
Tracheostomy tube collar/holder, each |
5,992 |
5,310 |
$319K |
| A4623 |
Tracheostomy, inner cannula |
2,519 |
2,001 |
$282K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
652 |
584 |
$200K |
| 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 |
248 |
218 |
$191K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
2,534 |
2,148 |
$173K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,489 |
2,274 |
$155K |
| 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 |
724 |
626 |
$134K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
3,982 |
3,539 |
$123K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
2,163 |
1,815 |
$117K |
| A4927 |
Gloves, non-sterile, per 100 |
5,910 |
5,209 |
$88K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,880 |
3,042 |
$87K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
711 |
637 |
$80K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
5,784 |
4,851 |
$76K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
718 |
694 |
$71K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
2,933 |
2,450 |
$65K |
| 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 |
244 |
212 |
$57K |
| B9002 |
Enteral nutrition infusion pump, any type |
914 |
797 |
$51K |
| A7000 |
Canister, disposable, used with suction pump, each |
5,828 |
5,221 |
$45K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
1,500 |
1,307 |
$40K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
477 |
369 |
$27K |
| A4649 |
Surgical supply; miscellaneous |
811 |
745 |
$20K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
3,817 |
3,283 |
$20K |
| 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 |
86 |
61 |
$19K |
| A4452 |
Tape, waterproof, per 18 square inches |
2,510 |
2,214 |
$16K |
| 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 |
53 |
51 |
$14K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
5,046 |
4,251 |
$14K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
6,122 |
5,236 |
$10K |
| A7002 |
Tubing, used with suction pump, each |
2,858 |
2,582 |
$9K |
| A4657 |
Syringe, with or without needle, each |
4,945 |
4,106 |
$8K |
| A7012 |
Water collection device, used with large volume nebulizer |
2,674 |
2,227 |
$7K |
| E0776 |
Iv pole |
853 |
722 |
$5K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
2,031 |
1,733 |
$5K |
| A7525 |
Tracheostomy mask, each |
2,838 |
2,491 |
$4K |
| A4332 |
Lubricant, individual sterile packet, each |
3,204 |
2,712 |
$3K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
110 |
94 |
$2K |
| E0570 |
Nebulizer, with compressor |
59 |
59 |
$1K |
| 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 |
51 |
49 |
$912.45 |
| L8501 |
Tracheostomy speaking valve |
12 |
12 |
$687.12 |
| A7015 |
Aerosol mask, used with dme nebulizer |
391 |
322 |
$486.41 |