| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
41,410 |
36,588 |
$9.08M |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
10,221 |
8,971 |
$6.83M |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
13,998 |
11,445 |
$5.10M |
| 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 |
9,836 |
7,922 |
$4.57M |
| S8189 |
Tracheostomy supply, not otherwise classified |
38,418 |
14,151 |
$3.11M |
| 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 |
17,527 |
14,825 |
$3.01M |
| T4541 |
Incontinence product, disposable underpad, large, each |
53,934 |
50,452 |
$2.80M |
| B9998 |
Noc for enteral supplies |
37,246 |
27,238 |
$2.37M |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
22,394 |
19,062 |
$2.16M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
30,143 |
26,331 |
$2.08M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
13,326 |
12,395 |
$1.94M |
| 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 |
5,788 |
4,780 |
$1.74M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
15,244 |
14,382 |
$1.71M |
| 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 |
6,156 |
5,263 |
$1.71M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
24,626 |
23,174 |
$1.54M |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
21,838 |
17,818 |
$1.53M |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
1,772 |
1,591 |
$1.50M |
| A4927 |
Gloves, non-sterile, per 100 |
67,543 |
60,751 |
$1.50M |
| E1399 |
Durable medical equipment, miscellaneous |
8,384 |
5,506 |
$1.44M |
| 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 |
2,470 |
2,189 |
$1.44M |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
11,574 |
10,891 |
$1.34M |
| A7526 |
Tracheostomy tube collar/holder, each |
15,796 |
13,842 |
$1.28M |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
11,588 |
8,909 |
$1.28M |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
7,993 |
6,575 |
$1.15M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
5,945 |
5,616 |
$1.07M |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
22,626 |
14,977 |
$991K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
9,292 |
8,036 |
$955K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
4,963 |
4,213 |
$928K |
| B9002 |
Enteral nutrition infusion pump, any type |
9,379 |
7,412 |
$897K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
5,846 |
5,420 |
$861K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
6,012 |
5,606 |
$814K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
5,073 |
4,696 |
$809K |
| A4657 |
Syringe, with or without needle, each |
26,683 |
23,394 |
$802K |
| 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 |
4,708 |
3,998 |
$734K |
| 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 |
3,922 |
3,252 |
$635K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,946 |
3,725 |
$578K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
5,854 |
4,439 |
$556K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,635 |
2,335 |
$542K |
| A4623 |
Tracheostomy, inner cannula |
4,183 |
3,529 |
$539K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
18,223 |
16,048 |
$516K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
4,162 |
3,918 |
$513K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
2,287 |
1,905 |
$493K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
17,657 |
15,524 |
$472K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
2,774 |
2,617 |
$461K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
696 |
611 |
$442K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
23,126 |
20,345 |
$440K |
| A7000 |
Canister, disposable, used with suction pump, each |
25,226 |
21,905 |
$412K |
| A4217 |
Sterile water/saline, 500 ml |
10,987 |
9,345 |
$370K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
24,621 |
21,207 |
$365K |
| 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 |
1,098 |
944 |
$279K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
737 |
656 |
$267K |
| A4554 |
Disposable underpads, all sizes |
5,502 |
5,045 |
$260K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
3,389 |
2,863 |
$257K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
3,786 |
3,069 |
$231K |
| A7002 |
Tubing, used with suction pump, each |
24,622 |
21,878 |
$228K |
| A5200 |
Percutaneous catheter/tube anchoring device, adhesive skin attachment |
5,777 |
4,881 |
$223K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,421 |
1,301 |
$222K |
| A6403 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing |
3,762 |
3,286 |
$207K |
| 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 |
1,502 |
1,276 |
$205K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
3,414 |
2,740 |
$198K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,324 |
1,973 |
$198K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
11,095 |
10,148 |
$189K |
| A4245 |
Alcohol wipes, per box |
12,904 |
11,299 |
$187K |
| L8501 |
Tracheostomy speaking valve |
2,094 |
1,848 |
$176K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
740 |
671 |
$172K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
3,776 |
3,157 |
$171K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
3,586 |
2,770 |
$171K |
| 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 |
5,478 |
4,847 |
$171K |
| B4103 |
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
1,498 |
1,287 |
$169K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,323 |
1,143 |
$158K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,832 |
1,668 |
$154K |
| A4605 |
Tracheal suction catheter, closed system, each |
714 |
619 |
$153K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,337 |
1,169 |
$133K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
25,048 |
22,060 |
$108K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
875 |
822 |
$107K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
591 |
517 |
$106K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
2,075 |
1,875 |
$91K |
| E0570 |
Nebulizer, with compressor |
2,262 |
1,974 |
$90K |
| A4210 |
Needle-free injection device, each |
9,364 |
6,812 |
$89K |
| E0776 |
Iv pole |
1,904 |
1,492 |
$86K |
| B4102 |
Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
441 |
380 |
$74K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
310 |
252 |
$71K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
8,097 |
6,945 |
$65K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
776 |
638 |
$65K |
| A4553 |
Non-disposable underpads, all sizes |
4,237 |
3,960 |
$62K |
| A4452 |
Tape, waterproof, per 18 square inches |
3,033 |
2,729 |
$59K |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
83 |
74 |
$56K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
581 |
480 |
$56K |
| A5120 |
Skin barrier, wipes or swabs, each |
4,664 |
3,817 |
$55K |
| A7525 |
Tracheostomy mask, each |
7,971 |
6,867 |
$52K |
| T5999 |
Supply, not otherwise specified |
1,459 |
985 |
$50K |
| A4402 |
Lubricant, per ounce |
9,029 |
8,114 |
$50K |
| A4456 |
Adhesive remover, wipes, any type, each |
4,086 |
3,511 |
$49K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
13,340 |
11,892 |
$48K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
558 |
478 |
$47K |
| A6260 |
Wound cleansers, any type, any size |
2,798 |
2,405 |
$46K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
1,743 |
1,572 |
$44K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
450 |
386 |
$42K |
| A7012 |
Water collection device, used with large volume nebulizer |
5,370 |
4,685 |
$41K |
| A4332 |
Lubricant, individual sterile packet, each |
3,307 |
2,957 |
$40K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
2,261 |
1,989 |
$39K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
2,913 |
2,581 |
$39K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,729 |
1,333 |
$38K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
1,135 |
874 |
$38K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
344 |
271 |
$35K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,155 |
1,937 |
$35K |
| A4930 |
Gloves, sterile, per pair |
506 |
448 |
$34K |
| A7018 |
Water, distilled, used with large volume nebulizer, 1000 ml |
11,970 |
10,536 |
$33K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
472 |
340 |
$32K |
| K0001 |
Standard wheelchair |
1,826 |
1,490 |
$32K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
23,686 |
19,146 |
$21K |
| A7037 |
Tubing used with positive airway pressure device |
1,673 |
1,477 |
$21K |
| E0619 |
Apnea monitor, with recording feature |
111 |
89 |
$20K |
| S8186 |
Swivel adapter |
2,647 |
2,398 |
$20K |
| E0601 |
Continuous positive airway pressure (cpap) device |
441 |
398 |
$20K |
| A7031 |
Face mask interface, replacement for full face mask, each |
604 |
541 |
$18K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
379 |
330 |
$17K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
579 |
518 |
$17K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
175 |
145 |
$17K |
| B4100 |
Food thickener, administered orally, per ounce |
88 |
80 |
$16K |
| E0439 |
Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing |
110 |
107 |
$15K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,930 |
1,574 |
$15K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
153 |
139 |
$14K |
| A4335 |
Incontinence supply; miscellaneous |
5,442 |
5,333 |
$14K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
210 |
188 |
$13K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
236 |
212 |
$12K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
324 |
288 |
$11K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
68 |
62 |
$11K |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
4,912 |
4,361 |
$10K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,968 |
2,568 |
$10K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,040 |
975 |
$10K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
106 |
92 |
$9K |
| A7030 |
Full face mask used with positive airway pressure device, each |
109 |
99 |
$8K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
57 |
51 |
$8K |
| B9999 |
Noc for parenteral supplies |
88 |
66 |
$8K |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
2,441 |
2,265 |
$7K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
434 |
413 |
$7K |
| S8121 |
Oxygen contents, liquid, 1 unit equals 1 pound |
121 |
69 |
$7K |
| A4616 |
Tubing (oxygen), per foot |
4,249 |
3,664 |
$7K |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
261 |
253 |
$6K |
| B4082 |
Nasogastric tubing without stylet |
202 |
153 |
$6K |
| A4615 |
Cannula, nasal |
2,426 |
2,197 |
$6K |
| A4371 |
Ostomy skin barrier, powder, per oz |
1,310 |
1,199 |
$6K |
| A7035 |
Headgear used with positive airway pressure device |
355 |
301 |
$5K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
522 |
522 |
$5K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
510 |
418 |
$5K |
| A4618 |
Breathing circuits |
221 |
193 |
$5K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
174 |
159 |
$4K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
338 |
264 |
$4K |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
13 |
12 |
$3K |
| A4322 |
Irrigation syringe, bulb or piston, each |
89 |
79 |
$3K |
| L7367 |
Lithium ion battery, rechargeable, replacement |
29 |
25 |
$3K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
16 |
16 |
$3K |
| A4247 |
Betadine or iodine swabs/wipes, per box |
91 |
83 |
$3K |
| 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) |
15 |
12 |
$2K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
12 |
12 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
373 |
322 |
$2K |
| A4649 |
Surgical supply; miscellaneous |
13 |
13 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
41 |
37 |
$1K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
86 |
76 |
$1K |
| S8999 |
Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event) |
44 |
38 |
$918.79 |
| S8120 |
Oxygen contents, gaseous, 1 unit equals 1 cubic foot |
30 |
25 |
$628.44 |
| A7527 |
Tracheostomy/laryngectomy tube plug/stop, each |
62 |
49 |
$603.59 |
| A7020 |
Interface for cough stimulating device, includes all components, replacement only |
48 |
38 |
$419.21 |
| A9270 |
Non-covered item or service |
424 |
360 |
$132.42 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
16 |
12 |
$89.80 |
| A4244 |
Alcohol or peroxide, per pint |
12 |
12 |
$14.83 |