| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
9,111 |
8,225 |
$6.66M |
| B4035 |
Enteral feed supp pump per d |
27,098 |
22,701 |
$6.66M |
| B9998 |
Enteral supp not otherwise c |
40,199 |
27,332 |
$4.08M |
| E0465 |
Home vent invasive interface |
5,529 |
5,083 |
$3.98M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
11,109 |
9,907 |
$3.32M |
| B4149 |
Ef blenderized foods |
5,732 |
5,055 |
$2.26M |
| E0466 |
Home vent non-invasive inter |
3,018 |
2,927 |
$2.13M |
| E1390 |
Oxygen concentrator |
18,710 |
18,133 |
$2.08M |
| B4153 |
Ef hydrolyzed/amino acids |
2,132 |
1,323 |
$1.58M |
| A4606 |
Oxygen probe used w oximeter |
22,363 |
11,169 |
$1.47M |
| B4155 |
Ef incomplete/modular |
5,468 |
4,848 |
$1.27M |
| E0482 |
Cough stimulating device |
4,819 |
4,641 |
$1.17M |
| E0445 |
Oximeter non-invasive |
5,957 |
5,763 |
$1.11M |
| B9002 |
Enter nutr inf pump any type |
7,365 |
7,181 |
$823K |
| A4624 |
Tracheal suction tube |
6,386 |
5,630 |
$696K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
4,962 |
3,872 |
$693K |
| A4605 |
Trach suction cath close sys |
4,826 |
3,850 |
$666K |
| B4154 |
Ef spec metabolic noninherit |
1,448 |
1,155 |
$661K |
| B4150 |
Ef complet w/intact nutrient |
3,101 |
2,453 |
$605K |
| A7000 |
Disposable canister for pump |
19,787 |
15,773 |
$588K |
| A4629 |
Tracheostomy care kit |
6,690 |
6,098 |
$587K |
| E0471 |
Rad w/backup non inv intrfc |
1,833 |
1,771 |
$570K |
| A4353 |
Intermittent urinary cath |
993 |
820 |
$504K |
| B4158 |
Ef ped complete intact nut |
2,269 |
2,026 |
$484K |
| A4554 |
Disposable underpads |
15,067 |
13,809 |
$464K |
| T4530 |
Ped size brief/diaper lg |
5,731 |
4,772 |
$453K |
| B4104 |
Additive for enteral formula |
2,845 |
2,745 |
$384K |
| A7520 |
Trach/laryn tube non-cuffed |
5,431 |
4,783 |
$363K |
| E0431 |
Portable gaseous 02 |
17,845 |
17,367 |
$345K |
| B4034 |
Enter feed supkit syr by day |
3,666 |
2,309 |
$339K |
| T4522 |
Adult size brief/diaper med |
3,261 |
3,055 |
$327K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
5,123 |
4,737 |
$276K |
| T4534 |
Youth size pull-on |
2,783 |
2,332 |
$266K |
| A7526 |
Tracheostomy tube collar |
9,469 |
7,235 |
$264K |
| E0600 |
Suction pump portab hom modl |
2,011 |
1,715 |
$250K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,036 |
893 |
$249K |
| A7521 |
Trach/laryn tube cuffed |
2,698 |
2,371 |
$236K |
| A7002 |
Tubing used w suction pump |
22,008 |
16,449 |
$228K |
| T4523 |
Adult size brief/diaper lg |
2,099 |
1,822 |
$213K |
| A4322 |
Irrigation syringe |
21,399 |
19,356 |
$193K |
| E1399 |
Durable medical equipment mi |
483 |
443 |
$169K |
| E0601 |
Cont airway pressure device |
2,664 |
2,600 |
$150K |
| T1999 |
Noc retail items andsupplies |
33,785 |
21,941 |
$148K |
| E0470 |
Rad w/o backup non-inv intfc |
920 |
869 |
$145K |
| T4521 |
Adult size brief/diaper sm |
1,398 |
1,294 |
$131K |
| A4335 |
Incontinence supply |
19,734 |
17,983 |
$130K |
| A4216 |
Sterile water/saline, 10 ml |
10,135 |
6,603 |
$118K |
| A4351 |
Straight tip urine catheter |
769 |
687 |
$108K |
| E0483 |
Hi freq chest wall oscil sys |
151 |
142 |
$105K |
| A4628 |
Oropharyngeal suction cath |
18,158 |
15,295 |
$102K |
| B4103 |
Ef ped fluid and electrolyte |
836 |
749 |
$100K |
| A9900 |
Supply/accessory/service |
4,399 |
3,234 |
$98K |
| A6402 |
Sterile gauze <= 16 sq in |
12,213 |
11,044 |
$87K |
| A6212 |
Foam drg <=16 sq in w/border |
514 |
454 |
$86K |
| A6258 |
Transparent film >16<=48 in |
3,491 |
3,193 |
$82K |
| T4526 |
Adult size pull-on med |
768 |
734 |
$79K |
| T4524 |
Adult size brief/diaper xl |
595 |
547 |
$74K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
275 |
193 |
$64K |
| E0776 |
Iv pole |
6,766 |
6,582 |
$55K |
| A4452 |
Waterproof tape |
7,624 |
6,867 |
$53K |
| T4528 |
Adult size pull-on xl |
295 |
293 |
$47K |
| B4036 |
Enteral feed sup kit grav by |
1,010 |
968 |
$46K |
| E0565 |
Compressor air power source |
1,417 |
1,386 |
$46K |
| A4927 |
Non-sterile gloves |
6,794 |
5,607 |
$43K |
| A4217 |
Sterile water/saline, 500 ml |
1,871 |
1,407 |
$42K |
| B4100 |
Food thickener oral |
1,347 |
1,259 |
$38K |
| A7003 |
Nebulizer administration set |
14,193 |
13,481 |
$36K |
| A6257 |
Transparent film <= 16 sq in |
1,888 |
1,349 |
$34K |
| A9279 |
Monitoring feature/devicenoc |
202 |
194 |
$31K |
| T4529 |
Ped size brief/diaper sm/med |
735 |
476 |
$30K |
| A5200 |
Percutaneous catheter anchor |
1,642 |
1,560 |
$30K |
| E0570 |
Nebulizer with compression |
294 |
288 |
$29K |
| A6250 |
Skin seal protect moisturizr |
1,576 |
1,409 |
$27K |
| A4623 |
Tracheostomy inner cannula |
574 |
512 |
$26K |
| A7034 |
Nasal application device |
470 |
455 |
$24K |
| A4402 |
Lubricant per ounce |
4,485 |
4,328 |
$22K |
| A4481 |
Tracheostoma filter |
2,408 |
1,698 |
$22K |
| T4525 |
Adult size pull-on sm |
203 |
156 |
$16K |
| B4082 |
Enteral ng tubing w/o stylet |
294 |
245 |
$16K |
| E0300 |
Enclosed ped crib hosp grade |
94 |
91 |
$16K |
| A7037 |
Pos airway pressure tubing |
964 |
875 |
$15K |
| E0260 |
Hosp bed semi-electr w/ matt |
151 |
147 |
$14K |
| T4535 |
Disposable liner/shield/pad |
567 |
503 |
$13K |
| K0001 |
Standard wheelchair |
402 |
389 |
$13K |
| T4532 |
Ped size pull-on lg |
108 |
75 |
$12K |
| A5120 |
Skin barrier, wipe or swab |
1,710 |
1,508 |
$11K |
| A6216 |
Non-sterile gauze<=16 sq in |
1,409 |
1,277 |
$11K |
| A7525 |
Tracheostomy mask |
3,921 |
3,641 |
$11K |
| A5131 |
Appliance cleaner |
1,166 |
712 |
$9K |
| A7012 |
Nebulizer water collec devic |
1,649 |
1,598 |
$7K |
| A4670 |
Automatic bp monitor, dial |
129 |
128 |
$6K |
| A7015 |
Aerosol mask used w nebulize |
4,739 |
4,241 |
$5K |
| T4531 |
Ped size pull-on sm/med |
44 |
39 |
$5K |
| A7046 |
Repl water chamber, pap dev |
423 |
387 |
$5K |
| A4213 |
20+ cc syringe only |
1,470 |
1,335 |
$4K |
| A4406 |
Pectin based ostomy paste |
181 |
168 |
$4K |
| A4310 |
Insert tray w/o bag/cath |
24 |
12 |
$4K |
| A4371 |
Skin barrier powder per oz |
588 |
557 |
$3K |
| A4450 |
Non-waterproof tape |
1,439 |
1,223 |
$3K |
| A7038 |
Pos airway pressure filter |
622 |
591 |
$2K |
| K0195 |
Elevating whlchair leg rests |
186 |
179 |
$2K |
| A4357 |
Bedside drainage bag |
75 |
49 |
$2K |
| A7005 |
Nondisposable nebulizer set |
108 |
101 |
$2K |
| S8999 |
Resuscitation bag |
14 |
14 |
$2K |
| A4245 |
Alcohol wipes per box |
770 |
722 |
$1K |
| A4456 |
Adhesive remover, wipes |
113 |
86 |
$945.97 |
| B4088 |
Gastro/jejuno tube, low-pro |
121 |
114 |
$935.37 |
| L8501 |
Tracheostomy speaking valve |
17 |
14 |
$897.52 |
| E0562 |
Humidifier heated used w pap |
79 |
78 |
$835.54 |
| A7010 |
Disposable corrugated tubing |
51 |
50 |
$744.74 |
| A4657 |
Syringe w/wo needle |
372 |
291 |
$571.59 |
| A4244 |
Alcohol or peroxide per pint |
723 |
702 |
$406.65 |
| A4332 |
Lube sterile packet |
128 |
116 |
$400.39 |
| A7013 |
Disposable compressor filter |
458 |
450 |
$289.05 |
| A4649 |
Surgical supplies |
92 |
82 |
$214.75 |
| A7039 |
Filter, non disposable w pap |
26 |
25 |
$143.91 |
| A7007 |
Lg vol nebulizer disposable |
12 |
12 |
$34.97 |