| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
22,161 |
18,345 |
$15.04M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
41,115 |
38,288 |
$10.71M |
| 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 |
11,269 |
10,451 |
$7.04M |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
16,699 |
16,028 |
$5.86M |
| A4605 |
Tracheal suction catheter, closed system, each |
12,583 |
12,221 |
$5.06M |
| 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 |
12,264 |
11,376 |
$4.41M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
42,629 |
24,415 |
$3.84M |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
22,038 |
20,729 |
$3.65M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
4,791 |
4,309 |
$3.51M |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
8,829 |
8,696 |
$3.46M |
| 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 |
11,204 |
10,504 |
$2.87M |
| A7526 |
Tracheostomy tube collar/holder, each |
27,571 |
26,537 |
$1.73M |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
11,598 |
10,877 |
$1.33M |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
14,355 |
13,737 |
$1.31M |
| A4629 |
Tracheostomy care kit for established tracheostomy |
12,696 |
12,159 |
$1.30M |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
14,058 |
13,463 |
$1.28M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
59,591 |
39,201 |
$1.14M |
| 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 |
5,103 |
4,834 |
$905K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
20,443 |
13,523 |
$875K |
| T4541 |
Incontinence product, disposable underpad, large, each |
10,391 |
9,929 |
$709K |
| B9002 |
Enteral nutrition infusion pump, any type |
15,033 |
8,835 |
$701K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
2,552 |
2,183 |
$692K |
| 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 |
1,450 |
1,357 |
$652K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
5,040 |
4,869 |
$633K |
| A6211 |
Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
2,323 |
2,196 |
$631K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
4,431 |
4,172 |
$475K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
10,765 |
9,664 |
$466K |
| A7000 |
Canister, disposable, used with suction pump, each |
36,598 |
35,190 |
$458K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
30,797 |
28,949 |
$458K |
| A4649 |
Surgical supply; miscellaneous |
16,959 |
15,529 |
$457K |
| A4927 |
Gloves, non-sterile, per 100 |
28,837 |
27,648 |
$422K |
| E0601 |
Continuous positive airway pressure (cpap) device |
11,033 |
5,392 |
$379K |
| 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 |
2,023 |
1,917 |
$367K |
| 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 |
1,106 |
1,034 |
$335K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
3,743 |
3,582 |
$328K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
4,306 |
4,110 |
$305K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
18,245 |
9,616 |
$303K |
| 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) |
875 |
847 |
$285K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
14,435 |
13,870 |
$239K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
3,161 |
3,053 |
$223K |
| A7002 |
Tubing, used with suction pump, each |
37,046 |
35,425 |
$214K |
| A4452 |
Tape, waterproof, per 18 square inches |
30,782 |
28,815 |
$211K |
| 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 |
2,148 |
1,948 |
$194K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
12,090 |
6,809 |
$192K |
| E1399 |
Durable medical equipment, miscellaneous |
1,237 |
1,004 |
$186K |
| A4623 |
Tracheostomy, inner cannula |
1,542 |
1,372 |
$178K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
10,904 |
9,758 |
$170K |
| 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 |
918 |
855 |
$167K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,303 |
1,172 |
$159K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,088 |
1,033 |
$147K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
1,465 |
1,359 |
$142K |
| A7018 |
Water, distilled, used with large volume nebulizer, 1000 ml |
29,555 |
28,388 |
$139K |
| A4322 |
Irrigation syringe, bulb or piston, each |
15,060 |
13,959 |
$121K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
4,898 |
3,197 |
$114K |
| 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 |
3,248 |
3,075 |
$103K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
3,582 |
3,444 |
$101K |
| 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) |
812 |
515 |
$101K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
28,795 |
27,415 |
$99K |
| E0570 |
Nebulizer, with compressor |
1,223 |
1,107 |
$91K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
12,763 |
11,801 |
$91K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,804 |
1,721 |
$82K |
| E0776 |
Iv pole |
11,472 |
8,161 |
$66K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
653 |
608 |
$63K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
365 |
346 |
$59K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
31,753 |
30,275 |
$57K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
813 |
658 |
$55K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
559 |
531 |
$54K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,397 |
1,370 |
$53K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
12,298 |
11,897 |
$49K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
422 |
407 |
$48K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
789 |
687 |
$40K |
| E0550 |
Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery |
1,927 |
1,337 |
$39K |
| A7035 |
Headgear used with positive airway pressure device |
1,190 |
1,109 |
$38K |
| A7012 |
Water collection device, used with large volume nebulizer |
6,243 |
5,983 |
$34K |
| A7037 |
Tubing used with positive airway pressure device |
935 |
875 |
$31K |
| A4217 |
Sterile water/saline, 500 ml |
2,448 |
2,234 |
$30K |
| A4332 |
Lubricant, individual sterile packet, each |
9,315 |
8,689 |
$29K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
854 |
811 |
$29K |
| E0441 |
Stationary oxygen contents, gaseous, 1 month's supply = 1 unit |
430 |
415 |
$27K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
6,189 |
5,969 |
$27K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
21,450 |
20,179 |
$25K |
| A7525 |
Tracheostomy mask, each |
11,584 |
11,177 |
$24K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
255 |
235 |
$23K |
| L8501 |
Tracheostomy speaking valve |
364 |
361 |
$22K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
1,410 |
1,345 |
$20K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,228 |
1,146 |
$19K |
| B4082 |
Nasogastric tubing without stylet |
1,783 |
1,545 |
$18K |
| B9998 |
Noc for enteral supplies |
1,532 |
1,267 |
$17K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
253 |
239 |
$16K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
101 |
88 |
$16K |
| E1392 |
Portable oxygen concentrator, rental |
521 |
441 |
$14K |
| A7527 |
Tracheostomy/laryngectomy tube plug/stop, each |
1,692 |
1,611 |
$14K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
13 |
12 |
$13K |
| E0555 |
Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter |
6,982 |
6,625 |
$12K |
| A7020 |
Interface for cough stimulating device, includes all components, replacement only |
873 |
845 |
$11K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
141 |
141 |
$10K |
| A7030 |
Full face mask used with positive airway pressure device, each |
64 |
55 |
$10K |
| A7015 |
Aerosol mask, used with dme nebulizer |
7,163 |
6,592 |
$10K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
522 |
473 |
$10K |
| K0462 |
Temporary replacement for patient owned equipment being repaired, any type |
187 |
180 |
$9K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,830 |
1,707 |
$7K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
383 |
363 |
$7K |
| 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 |
67 |
65 |
$5K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
353 |
333 |
$4K |
| E0425 |
Stationary compressed gas system, purchase; includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
39 |
39 |
$3K |
| A7031 |
Face mask interface, replacement for full face mask, each |
61 |
52 |
$3K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
826 |
766 |
$3K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
13 |
13 |
$1K |
| A4371 |
Ostomy skin barrier, powder, per oz |
291 |
248 |
$1K |
| A4554 |
Disposable underpads, all sizes |
121 |
120 |
$194.60 |
| A5200 |
Percutaneous catheter/tube anchoring device, adhesive skin attachment |
14 |
14 |
$154.86 |
| A4218 |
Sterile saline or water, metered dose dispenser, 10 ml |
584 |
509 |
$149.04 |
| A6450 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard |
49 |
49 |
$130.15 |
| A5120 |
Skin barrier, wipes or swabs, each |
13 |
12 |
$70.50 |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
403 |
354 |
$0.00 |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
50 |
44 |
$0.00 |