| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
714,650 |
671,149 |
$84.37M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
545,082 |
503,271 |
$58.28M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
779,210 |
723,775 |
$38.49M |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
343,529 |
315,701 |
$36.94M |
| A4554 |
Disposable underpads, all sizes |
935,132 |
767,372 |
$36.12M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
361,209 |
300,436 |
$33.31M |
| T4541 |
Incontinence product, disposable underpad, large, each |
712,566 |
674,299 |
$29.67M |
| A4927 |
Gloves, non-sterile, per 100 |
1,391,623 |
1,220,345 |
$29.53M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
312,374 |
262,382 |
$27.16M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
251,572 |
211,423 |
$25.09M |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
268,999 |
237,642 |
$18.43M |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
116,593 |
95,258 |
$16.82M |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
209,737 |
200,164 |
$11.50M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
63,101 |
55,077 |
$10.42M |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
17,118 |
13,406 |
$9.62M |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
102,781 |
94,563 |
$9.41M |
| A4467 |
Belt, strap, sleeve, garment, or covering, any type |
147,198 |
134,183 |
$8.36M |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
90,857 |
82,519 |
$7.43M |
| A4287 |
Disposable collection and storage bag for breast milk, any size, any type, each |
126,584 |
116,440 |
$6.83M |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
78,138 |
65,278 |
$6.28M |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
71,252 |
61,313 |
$6.21M |
| K1005 |
Disposable collection and storage bag for breast milk, any size, any type, each |
119,759 |
110,127 |
$5.80M |
| L2630 |
Addition to lower extremity, pelvic control, band and belt, unilateral |
37,121 |
34,784 |
$4.65M |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
32,262 |
30,083 |
$3.93M |
| E0570 |
Nebulizer, with compressor |
91,516 |
52,846 |
$3.64M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
36,398 |
28,125 |
$3.11M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
37,892 |
31,116 |
$3.00M |
| A4930 |
Gloves, sterile, per pair |
22,402 |
15,337 |
$2.32M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
24,566 |
19,232 |
$2.28M |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
23,454 |
17,082 |
$1.99M |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
18,114 |
16,394 |
$1.75M |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
34,730 |
33,364 |
$1.54M |
| E0601 |
Continuous positive airway pressure (cpap) device |
63,414 |
40,693 |
$1.35M |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
14,560 |
12,701 |
$1.23M |
| 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 |
17,321 |
12,530 |
$1.23M |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
29,926 |
27,462 |
$1.21M |
| A7030 |
Full face mask used with positive airway pressure device, each |
27,610 |
20,634 |
$1.19M |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
61,876 |
51,711 |
$1.18M |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
36,060 |
30,650 |
$1.16M |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
4,034 |
3,096 |
$1.13M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
49,689 |
17,451 |
$1.11M |
| L0641 |
Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
21,930 |
21,254 |
$1.07M |
| E0202 |
Phototherapy (bilirubin) light with photometer |
26,035 |
2,344 |
$946K |
| 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 |
9,916 |
7,327 |
$919K |
| A4335 |
Incontinence supply; miscellaneous |
144,080 |
107,618 |
$873K |
| T5999 |
Supply, not otherwise specified |
65,071 |
64,278 |
$828K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
28,201 |
23,241 |
$824K |
| A7031 |
Face mask interface, replacement for full face mask, each |
31,412 |
23,106 |
$782K |
| S5199 |
Personal care item, nos, each |
80,338 |
79,053 |
$739K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
10,870 |
8,471 |
$735K |
| A6245 |
Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
26,878 |
25,661 |
$719K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
14,465 |
10,879 |
$586K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
21,706 |
16,360 |
$579K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
16,038 |
12,045 |
$421K |
| A7035 |
Headgear used with positive airway pressure device |
32,179 |
25,107 |
$334K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
23,994 |
18,283 |
$328K |
| 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 |
2,210 |
2,098 |
$299K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
9,941 |
8,024 |
$298K |
| 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) |
7,964 |
4,670 |
$287K |
| A7037 |
Tubing used with positive airway pressure device |
24,989 |
18,484 |
$221K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
60,193 |
44,418 |
$192K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,821 |
1,145 |
$190K |
| A4282 |
Adapter for breast pump, replacement |
14,398 |
12,594 |
$174K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
8,871 |
6,156 |
$173K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
6,026 |
4,582 |
$169K |
| A4284 |
Breast shield and splash protector for use with breast pump, replacement |
14,570 |
12,798 |
$162K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
4,959 |
3,638 |
$158K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
1,634 |
427 |
$158K |
| A4281 |
Tubing for breast pump, replacement |
14,393 |
12,599 |
$156K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
19,861 |
14,828 |
$146K |
| 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 |
1,160 |
922 |
$142K |
| 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) |
1,168 |
777 |
$132K |
| 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 |
1,858 |
1,431 |
$126K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
1,570 |
1,190 |
$125K |
| 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 |
646 |
567 |
$118K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
6,224 |
2,813 |
$115K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
1,540 |
1,402 |
$111K |
| S9999 |
Sales tax |
12,361 |
12,351 |
$109K |
| A7015 |
Aerosol mask, used with dme nebulizer |
51,579 |
43,631 |
$103K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
21,042 |
17,349 |
$99K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
1,737 |
1,238 |
$98K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
1,745 |
1,462 |
$93K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
27,934 |
8,727 |
$92K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
4,062 |
2,583 |
$92K |
| A4217 |
Sterile water/saline, 500 ml |
5,297 |
3,493 |
$87K |
| A4617 |
Mouth piece |
27,359 |
24,489 |
$81K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
14,747 |
11,373 |
$78K |
| A4283 |
Cap for breast pump bottle, replacement |
14,216 |
12,652 |
$67K |
| A4285 |
Polycarbonate bottle for use with breast pump, replacement |
14,053 |
12,635 |
$62K |
| A7045 |
Exhalation port with or without swivel used with accessories for positive airway devices, replacement only |
13,573 |
10,768 |
$58K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
3,216 |
2,703 |
$56K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
8,409 |
6,330 |
$56K |
| E0619 |
Apnea monitor, with recording feature |
447 |
334 |
$55K |
| K0001 |
Standard wheelchair |
6,125 |
2,775 |
$54K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,235 |
595 |
$50K |
| A4553 |
Non-disposable underpads, all sizes |
3,683 |
3,121 |
$40K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
10,479 |
7,697 |
$40K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
66,007 |
55,012 |
$39K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
1,177 |
877 |
$38K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
2,763 |
2,073 |
$37K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
876 |
729 |
$35K |
| A4286 |
Locking ring for breast pump, replacement |
14,229 |
12,550 |
$35K |
| E0277 |
Powered pressure-reducing air mattress |
784 |
349 |
$35K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
1,378 |
302 |
$33K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
5,546 |
4,143 |
$32K |
| A4456 |
Adhesive remover, wipes, any type, each |
6,303 |
4,625 |
$32K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
970 |
717 |
$30K |
| A4400 |
Ostomy irrigation set |
546 |
459 |
$28K |
| E2402 |
Negative pressure wound therapy electrical pump, stationary or portable |
742 |
596 |
$28K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
2,709 |
2,201 |
$26K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
1,115 |
823 |
$25K |
| A4332 |
Lubricant, individual sterile packet, each |
5,597 |
4,611 |
$25K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
313 |
261 |
$24K |
| A4322 |
Irrigation syringe, bulb or piston, each |
3,441 |
2,605 |
$23K |
| A5120 |
Skin barrier, wipes or swabs, each |
5,249 |
3,697 |
$23K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
5,388 |
1,543 |
$19K |
| 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 |
4,119 |
1,096 |
$18K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,196 |
837 |
$16K |
| A4371 |
Ostomy skin barrier, powder, per oz |
2,877 |
2,254 |
$16K |
| A4402 |
Lubricant, per ounce |
4,932 |
3,768 |
$15K |
| A4331 |
Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each |
5,628 |
4,623 |
$15K |
| A6550 |
Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories |
498 |
362 |
$15K |
| A4452 |
Tape, waterproof, per 18 square inches |
1,718 |
1,299 |
$14K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
906 |
550 |
$14K |
| E0602 |
Breast pump, manual, any type |
2,345 |
2,010 |
$14K |
| A4340 |
Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each |
840 |
583 |
$13K |
| 94660 |
|
453 |
361 |
$13K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
3,624 |
2,119 |
$12K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
227 |
190 |
$10K |
| K0003 |
Lightweight wheelchair |
701 |
416 |
$8K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
346 |
235 |
$8K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,010 |
822 |
$8K |
| K0004 |
High strength, lightweight wheelchair |
389 |
325 |
$7K |
| 94799 |
|
354 |
303 |
$6K |
| A7000 |
Canister, disposable, used with suction pump, each |
615 |
429 |
$5K |
| E1392 |
Portable oxygen concentrator, rental |
1,634 |
528 |
$5K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,161 |
1,210 |
$5K |
| A7036 |
Chinstrap used with positive airway pressure device |
986 |
765 |
$4K |
| A4614 |
Peak expiratory flow rate meter, hand held |
203 |
189 |
$4K |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
2,849 |
2,282 |
$4K |
| A4334 |
Urinary catheter anchoring device, leg strap, each |
1,224 |
852 |
$3K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
1,043 |
784 |
$3K |
| A4367 |
Ostomy belt, each |
820 |
684 |
$2K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
40 |
37 |
$2K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
821 |
370 |
$2K |
| K0006 |
Heavy duty wheelchair |
203 |
73 |
$2K |
| A9278 |
Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
13 |
12 |
$1K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
333 |
123 |
$1K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
115 |
108 |
$1K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
27 |
25 |
$974.48 |
| E0627 |
Seat lift mechanism, electric, any type |
14 |
14 |
$971.74 |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
22 |
13 |
$925.09 |
| E0156 |
Seat attachment, walker |
238 |
182 |
$792.23 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
148 |
77 |
$612.79 |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
334 |
78 |
$461.14 |
| 99503 |
|
119 |
93 |
$386.00 |
| E1399 |
Durable medical equipment, miscellaneous |
65 |
51 |
$313.45 |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
177 |
114 |
$250.40 |
| E1353 |
Regulator |
272 |
227 |
$248.32 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
22 |
12 |
$215.42 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
28 |
27 |
$158.71 |
| E1355 |
Stand/rack |
946 |
571 |
$124.58 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
12 |
12 |
$96.41 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
41 |
36 |
$67.00 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
14 |
13 |
$45.51 |
| A4615 |
Cannula, nasal |
18 |
12 |
$11.65 |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
16 |
13 |
$0.01 |
| BILIMIS |
|
44 |
41 |
$0.00 |
| 99199 |
Unlisted special service, procedure or report |
1,125 |
480 |
$0.00 |