| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4606 |
Oxygen probe for use with oximeter device, replacement |
3,363 |
1,471 |
$683K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
4,059 |
2,828 |
$614K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
868 |
613 |
$442K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
3,908 |
2,064 |
$400K |
| B9998 |
Noc for enteral supplies |
7,866 |
3,343 |
$387K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,296 |
4,428 |
$380K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,376 |
898 |
$302K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
2,297 |
1,398 |
$102K |
| A4217 |
Sterile water/saline, 500 ml |
2,171 |
1,203 |
$99K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,447 |
982 |
$92K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
819 |
590 |
$75K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
218 |
153 |
$69K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
4,288 |
2,556 |
$50K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
13,625 |
2,097 |
$42K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
1,455 |
414 |
$41K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
618 |
419 |
$39K |
| E1392 |
Portable oxygen concentrator, rental |
1,316 |
1,104 |
$28K |
| B9002 |
Enteral nutrition infusion pump, any type |
79 |
63 |
$27K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
44 |
26 |
$25K |
| A7000 |
Canister, disposable, used with suction pump, each |
3,091 |
2,011 |
$19K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
209 |
166 |
$17K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
1,422 |
864 |
$15K |
| E0619 |
Apnea monitor, with recording feature |
93 |
74 |
$14K |
| A4927 |
Gloves, non-sterile, per 100 |
1,514 |
885 |
$10K |
| S8189 |
Tracheostomy supply, not otherwise classified |
92 |
65 |
$10K |
| A7002 |
Tubing, used with suction pump, each |
3,365 |
2,013 |
$7K |
| A4605 |
Tracheal suction catheter, closed system, each |
15 |
14 |
$6K |
| E0601 |
Continuous positive airway pressure (cpap) device |
257 |
227 |
$5K |
| A4930 |
Gloves, sterile, per pair |
132 |
79 |
$5K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
29 |
12 |
$5K |
| A4657 |
Syringe, with or without needle, each |
2,329 |
1,130 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,783 |
1,252 |
$4K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
767 |
328 |
$4K |
| A4402 |
Lubricant, per ounce |
773 |
525 |
$4K |
| A4322 |
Irrigation syringe, bulb or piston, each |
343 |
186 |
$3K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
31 |
28 |
$3K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
42 |
25 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
415 |
160 |
$886.32 |
| A7525 |
Tracheostomy mask, each |
86 |
61 |
$583.46 |
| A7030 |
Full face mask used with positive airway pressure device, each |
15 |
12 |
$436.20 |
| A4244 |
Alcohol or peroxide, per pint |
140 |
85 |
$241.80 |
| A7020 |
Interface for cough stimulating device, includes all components, replacement only |
15 |
12 |
$140.69 |