| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
15,899 |
11,220 |
$15.88M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
37,914 |
31,309 |
$9.80M |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
52,265 |
45,423 |
$8.05M |
| 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 |
19,437 |
14,848 |
$7.74M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
47,528 |
40,643 |
$6.52M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
5,962 |
4,981 |
$4.81M |
| 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 |
10,379 |
7,985 |
$3.52M |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
9,860 |
8,003 |
$2.87M |
| E1399 |
Durable medical equipment, miscellaneous |
22,764 |
9,670 |
$2.45M |
| 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 |
17,284 |
14,137 |
$2.17M |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
9,745 |
8,323 |
$1.81M |
| A4217 |
Sterile water/saline, 500 ml |
15,027 |
12,004 |
$1.66M |
| B9002 |
Enteral nutrition infusion pump, any type |
4,255 |
3,611 |
$1.65M |
| A4629 |
Tracheostomy care kit for established tracheostomy |
8,888 |
7,009 |
$1.53M |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
12,877 |
10,846 |
$1.28M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
48,251 |
41,699 |
$1.11M |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
7,035 |
6,086 |
$1.09M |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
8,001 |
6,074 |
$1.02M |
| A7526 |
Tracheostomy tube collar/holder, each |
16,529 |
14,112 |
$895K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
2,363 |
1,856 |
$637K |
| 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 |
5,092 |
4,089 |
$620K |
| 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 |
6,198 |
5,121 |
$599K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
3,080 |
2,394 |
$497K |
| A7000 |
Canister, disposable, used with suction pump, each |
18,418 |
16,096 |
$489K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
4,436 |
3,452 |
$467K |
| L8501 |
Tracheostomy speaking valve |
3,475 |
2,910 |
$419K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
1,622 |
1,287 |
$390K |
| E0619 |
Apnea monitor, with recording feature |
1,982 |
1,631 |
$388K |
| 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 |
1,156 |
900 |
$364K |
| 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 |
1,776 |
1,386 |
$294K |
| 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 |
2,009 |
1,622 |
$284K |
| B4103 |
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
2,941 |
2,384 |
$277K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
2,007 |
1,615 |
$259K |
| A4623 |
Tracheostomy, inner cannula |
1,410 |
1,021 |
$245K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
14,255 |
12,336 |
$152K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,962 |
1,700 |
$144K |
| E0776 |
Iv pole |
1,561 |
1,316 |
$133K |
| A4554 |
Disposable underpads, all sizes |
3,262 |
2,652 |
$132K |
| B9998 |
Noc for enteral supplies |
7,740 |
5,915 |
$111K |
| A7002 |
Tubing, used with suction pump, each |
17,245 |
15,074 |
$108K |
| E0570 |
Nebulizer, with compressor |
1,355 |
1,026 |
$102K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
1,528 |
1,241 |
$100K |
| A4605 |
Tracheal suction catheter, closed system, each |
2,429 |
1,908 |
$84K |
| B4100 |
Food thickener, administered orally, per ounce |
1,355 |
1,148 |
$82K |
| A4927 |
Gloves, non-sterile, per 100 |
6,306 |
5,317 |
$78K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
804 |
589 |
$49K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
515 |
413 |
$46K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
5,126 |
4,528 |
$46K |
| 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) |
226 |
215 |
$41K |
| A7012 |
Water collection device, used with large volume nebulizer |
4,904 |
4,323 |
$38K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
2,447 |
2,170 |
$38K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
362 |
306 |
$37K |
| A7525 |
Tracheostomy mask, each |
7,101 |
5,949 |
$33K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
13,649 |
11,737 |
$33K |
| 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 |
640 |
535 |
$19K |
| A4402 |
Lubricant, per ounce |
4,462 |
3,732 |
$18K |
| A7030 |
Full face mask used with positive airway pressure device, each |
100 |
95 |
$15K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
63 |
59 |
$14K |
| A4244 |
Alcohol or peroxide, per pint |
9,702 |
7,820 |
$11K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
119 |
102 |
$9K |
| A4245 |
Alcohol wipes, per box |
4,023 |
3,312 |
$9K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
93 |
66 |
$8K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,876 |
2,494 |
$6K |
| A7037 |
Tubing used with positive airway pressure device |
167 |
162 |
$6K |
| A7035 |
Headgear used with positive airway pressure device |
198 |
185 |
$6K |
| A7031 |
Face mask interface, replacement for full face mask, each |
117 |
80 |
$5K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
27 |
24 |
$3K |
| B4081 |
Nasogastric tubing with stylet |
119 |
105 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
335 |
215 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
274 |
248 |
$1K |
| B4104 |
Additive for enteral formula (e.g., fiber) |
109 |
89 |
$1K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
21 |
13 |
$1K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
614 |
507 |
$1K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
34 |
26 |
$818.79 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
29 |
25 |
$734.04 |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
13 |
12 |
$507.49 |
| B4082 |
Nasogastric tubing without stylet |
27 |
25 |
$382.95 |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
699 |
529 |
$280.00 |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
26 |
24 |
$177.84 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
134 |
90 |
$144.11 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
340 |
229 |
$131.40 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
19 |
12 |
$71.37 |