| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
2,656 |
1,495 |
$2.96M |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
10,651 |
6,606 |
$2.29M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
22,003 |
19,038 |
$1.96M |
| 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 |
2,388 |
1,873 |
$1.89M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
9,846 |
8,715 |
$1.78M |
| B9998 |
Noc for enteral supplies |
9,306 |
8,299 |
$1.27M |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
3,779 |
3,206 |
$1.16M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,890 |
1,732 |
$915K |
| B9002 |
Enteral nutrition infusion pump, any type |
11,333 |
11,011 |
$894K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,371 |
1,246 |
$869K |
| E0570 |
Nebulizer, with compressor |
15,442 |
13,782 |
$866K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
9,985 |
9,599 |
$685K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
20,931 |
18,196 |
$495K |
| K0001 |
Standard wheelchair |
21,965 |
19,123 |
$437K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
5,347 |
4,980 |
$420K |
| 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 |
1,957 |
1,732 |
$409K |
| E0619 |
Apnea monitor, with recording feature |
2,236 |
2,056 |
$319K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,087 |
2,737 |
$302K |
| A4208 |
Syringe with needle, sterile 3 cc, each |
2,291 |
2,001 |
$273K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
4,472 |
3,773 |
$236K |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
4,732 |
4,236 |
$235K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
3,058 |
2,940 |
$209K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
4,138 |
3,758 |
$208K |
| 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 |
534 |
473 |
$205K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
3,267 |
2,768 |
$204K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
1,191 |
1,098 |
$202K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,310 |
3,984 |
$179K |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
1,774 |
1,577 |
$163K |
| 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 |
1,014 |
857 |
$159K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
5,182 |
4,967 |
$154K |
| A7508 |
Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each |
3,358 |
2,832 |
$152K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,614 |
1,585 |
$151K |
| A4554 |
Disposable underpads, all sizes |
3,640 |
3,208 |
$141K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
2,987 |
2,553 |
$138K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
14,501 |
13,518 |
$137K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,194 |
1,083 |
$119K |
| A4322 |
Irrigation syringe, bulb or piston, each |
4,065 |
3,667 |
$112K |
| A4217 |
Sterile water/saline, 500 ml |
3,784 |
3,348 |
$110K |
| 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 |
641 |
555 |
$103K |
| A4927 |
Gloves, non-sterile, per 100 |
6,077 |
5,500 |
$100K |
| 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 |
115 |
100 |
$91K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
6,315 |
5,555 |
$85K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
6,279 |
3,880 |
$84K |
| A7000 |
Canister, disposable, used with suction pump, each |
6,095 |
5,327 |
$74K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
7,575 |
7,192 |
$72K |
| 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) |
602 |
570 |
$70K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,840 |
1,690 |
$67K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
15,883 |
12,940 |
$66K |
| A7526 |
Tracheostomy tube collar/holder, each |
3,882 |
3,333 |
$64K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
934 |
826 |
$63K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
2,453 |
1,903 |
$63K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
207 |
167 |
$57K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
414 |
390 |
$52K |
| K0006 |
Heavy duty wheelchair |
944 |
872 |
$50K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,396 |
1,203 |
$46K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
724 |
634 |
$45K |
| E0776 |
Iv pole |
5,276 |
5,105 |
$44K |
| A4245 |
Alcohol wipes, per box |
3,509 |
3,077 |
$42K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
917 |
825 |
$41K |
| A7002 |
Tubing, used with suction pump, each |
6,366 |
5,561 |
$38K |
| L8501 |
Tracheostomy speaking valve |
361 |
335 |
$34K |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
6,006 |
5,266 |
$34K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
3,340 |
2,853 |
$34K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
417 |
360 |
$33K |
| A4371 |
Ostomy skin barrier, powder, per oz |
1,232 |
1,061 |
$27K |
| K0003 |
Lightweight wheelchair |
1,891 |
1,769 |
$25K |
| A4332 |
Lubricant, individual sterile packet, each |
1,974 |
1,675 |
$23K |
| E1236 |
Wheelchair, pediatric size, folding, adjustable, with seating system |
38 |
37 |
$21K |
| A4605 |
Tracheal suction catheter, closed system, each |
1,235 |
1,061 |
$21K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
774 |
673 |
$20K |
| A4244 |
Alcohol or peroxide, per pint |
3,133 |
2,727 |
$20K |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
1,183 |
1,011 |
$17K |
| A4452 |
Tape, waterproof, per 18 square inches |
613 |
552 |
$15K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
802 |
795 |
$15K |
| E0156 |
Seat attachment, walker |
2,083 |
1,800 |
$15K |
| E1392 |
Portable oxygen concentrator, rental |
337 |
321 |
$14K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
127 |
115 |
$13K |
| 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 |
190 |
180 |
$13K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,097 |
931 |
$12K |
| A7015 |
Aerosol mask, used with dme nebulizer |
8,654 |
8,327 |
$10K |
| A7525 |
Tracheostomy mask, each |
2,161 |
1,744 |
$9K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
192 |
164 |
$8K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
712 |
504 |
$8K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
420 |
363 |
$8K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
287 |
211 |
$7K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
354 |
296 |
$6K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,183 |
834 |
$5K |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
113 |
109 |
$5K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
411 |
355 |
$4K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,075 |
777 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
487 |
394 |
$2K |
| K0004 |
High strength, lightweight wheelchair |
851 |
724 |
$2K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
341 |
296 |
$2K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
130 |
117 |
$2K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
86 |
58 |
$2K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
134 |
117 |
$2K |
| A4623 |
Tracheostomy, inner cannula |
85 |
67 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
73 |
57 |
$1K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
22 |
14 |
$1K |
| E0550 |
Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery |
26 |
25 |
$1K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
208 |
173 |
$785.49 |
| K0800 |
Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds |
15 |
12 |
$652.67 |
| A4335 |
Incontinence supply; miscellaneous |
71 |
66 |
$590.37 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
36 |
24 |
$525.21 |
| A7012 |
Water collection device, used with large volume nebulizer |
229 |
194 |
$371.35 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
145 |
89 |
$197.30 |
| A7030 |
Full face mask used with positive airway pressure device, each |
20 |
12 |
$193.24 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
15 |
14 |
$176.82 |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
12 |
12 |
$162.12 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
14 |
13 |
$156.17 |
| A7037 |
Tubing used with positive airway pressure device |
142 |
95 |
$96.75 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
24 |
24 |
$0.00 |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
33 |
26 |
$0.00 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
25 |
16 |
$0.00 |