| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4606 |
Oxygen probe for use with oximeter device, replacement |
6,216 |
2,750 |
$1.23M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
6,982 |
4,410 |
$874K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
4,129 |
2,422 |
$742K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,479 |
1,078 |
$719K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
8,915 |
7,319 |
$717K |
| B9998 |
Noc for enteral supplies |
13,463 |
5,173 |
$702K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
4,171 |
2,295 |
$427K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
3,069 |
1,406 |
$352K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
339 |
279 |
$206K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
2,837 |
781 |
$199K |
| A7526 |
Tracheostomy tube collar/holder, each |
3,701 |
2,074 |
$179K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
5,166 |
3,267 |
$160K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,844 |
1,340 |
$142K |
| A4217 |
Sterile water/saline, 500 ml |
4,914 |
2,302 |
$99K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
905 |
646 |
$87K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,027 |
790 |
$82K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
27,292 |
4,568 |
$81K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
2,181 |
1,312 |
$73K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
6,657 |
4,054 |
$69K |
| A7508 |
Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each |
2,492 |
779 |
$54K |
| S8189 |
Tracheostomy supply, not otherwise classified |
1,282 |
525 |
$54K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
440 |
246 |
$49K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
30 |
14 |
$37K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
3,052 |
1,625 |
$37K |
| A7000 |
Canister, disposable, used with suction pump, each |
6,573 |
4,064 |
$31K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,287 |
857 |
$29K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
364 |
113 |
$24K |
| A4930 |
Gloves, sterile, per pair |
555 |
347 |
$24K |
| A4927 |
Gloves, non-sterile, per 100 |
3,317 |
1,990 |
$22K |
| A7002 |
Tubing, used with suction pump, each |
7,784 |
4,054 |
$15K |
| A7525 |
Tracheostomy mask, each |
2,797 |
1,184 |
$9K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
1,361 |
798 |
$9K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
270 |
194 |
$7K |
| A4402 |
Lubricant, per ounce |
1,941 |
1,153 |
$6K |
| E0601 |
Continuous positive airway pressure (cpap) device |
154 |
127 |
$5K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
4,030 |
2,467 |
$5K |
| 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 |
147 |
126 |
$5K |
| E0570 |
Nebulizer, with compressor |
85 |
63 |
$4K |
| A4657 |
Syringe, with or without needle, each |
2,749 |
1,607 |
$3K |
| A4322 |
Irrigation syringe, bulb or piston, each |
297 |
158 |
$3K |
| K0003 |
Lightweight wheelchair |
310 |
228 |
$3K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
680 |
337 |
$2K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
20 |
12 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
722 |
275 |
$2K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
32 |
12 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
62 |
50 |
$1K |
| E1392 |
Portable oxygen concentrator, rental |
40 |
36 |
$1K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
194 |
71 |
$966.78 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
84 |
67 |
$914.39 |
| A4244 |
Alcohol or peroxide, per pint |
1,076 |
516 |
$819.74 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
41 |
13 |
$349.69 |
| A4332 |
Lubricant, individual sterile packet, each |
121 |
56 |
$269.19 |
| A7037 |
Tubing used with positive airway pressure device |
13 |
12 |
$255.51 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
14 |
13 |
$96.80 |