| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
33,696 |
30,235 |
$8.56M |
| B4161 |
Ef ped hydrolyzed/amino acid |
7,976 |
6,722 |
$5.23M |
| E0465 |
Home vent invasive interface |
3,457 |
3,023 |
$2.41M |
| B4149 |
Ef blenderized foods |
3,985 |
3,338 |
$1.94M |
| A4624 |
Tracheal suction tube |
4,366 |
3,925 |
$1.90M |
| T4534 |
Youth size pull-on |
10,121 |
8,175 |
$1.85M |
| E1390 |
Oxygen concentrator |
16,494 |
15,384 |
$1.71M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
6,376 |
5,495 |
$1.62M |
| B4088 |
Gastro/jejuno tube, low-pro |
11,270 |
10,444 |
$1.19M |
| A4606 |
Oxygen probe used w oximeter |
10,663 |
8,504 |
$1.02M |
| A4554 |
Disposable underpads |
19,014 |
15,007 |
$796K |
| T4533 |
Youth size brief/diaper |
6,970 |
5,960 |
$791K |
| A4483 |
Moisture exchanger |
5,755 |
4,178 |
$770K |
| B4153 |
Ef hydrolyzed/amino acids |
1,129 |
993 |
$767K |
| T4526 |
Adult size pull-on med |
4,787 |
3,642 |
$753K |
| A7520 |
Trach/laryn tube non-cuffed |
5,526 |
4,772 |
$753K |
| E0445 |
Oximeter non-invasive |
4,229 |
3,438 |
$595K |
| A4351 |
Straight tip urine catheter |
2,563 |
2,182 |
$577K |
| T4525 |
Adult size pull-on sm |
4,061 |
3,249 |
$573K |
| T4532 |
Ped size pull-on lg |
3,533 |
3,033 |
$573K |
| A7526 |
Tracheostomy tube collar |
5,981 |
5,466 |
$560K |
| A4353 |
Intermittent urinary cath |
646 |
562 |
$500K |
| B9998 |
Enteral supp not otherwise c |
2,226 |
1,902 |
$470K |
| A4605 |
Trach suction cath close sys |
1,460 |
1,351 |
$455K |
| T4521 |
Adult size brief/diaper sm |
3,816 |
3,214 |
$419K |
| T4530 |
Ped size brief/diaper lg |
4,214 |
3,442 |
$418K |
| T4522 |
Adult size brief/diaper med |
3,733 |
3,238 |
$410K |
| B4150 |
Ef complet w/intact nutrient |
1,559 |
1,326 |
$319K |
| E0431 |
Portable gaseous 02 |
13,704 |
12,669 |
$292K |
| A4520 |
Incontinence garment anytype |
2,700 |
1,678 |
$289K |
| T4527 |
Adult size pull-on lg |
1,821 |
1,312 |
$284K |
| A4629 |
Tracheostomy care kit |
2,896 |
2,710 |
$262K |
| B9002 |
Enter nutr inf pump any type |
2,722 |
2,080 |
$245K |
| E0570 |
Nebulizer with compression |
3,864 |
3,131 |
$240K |
| B4034 |
Enter feed supkit syr by day |
1,913 |
1,712 |
$229K |
| E0466 |
Home vent non-invasive inter |
334 |
292 |
$221K |
| T4523 |
Adult size brief/diaper lg |
1,726 |
1,411 |
$218K |
| B4152 |
Ef calorie dense>/=1.5kcal |
923 |
808 |
$211K |
| A4927 |
Non-sterile gloves |
19,634 |
16,150 |
$209K |
| A7000 |
Disposable canister for pump |
9,176 |
8,532 |
$197K |
| A4628 |
Oropharyngeal suction cath |
7,907 |
7,106 |
$193K |
| A7034 |
Nasal application device |
2,826 |
2,431 |
$191K |
| L8501 |
Tracheostomy speaking valve |
1,985 |
1,842 |
$187K |
| B4155 |
Ef incomplete/modular |
2,289 |
2,023 |
$178K |
| T4535 |
Disposable liner/shield/pad |
3,125 |
2,603 |
$152K |
| E0601 |
Cont airway pressure device |
486 |
421 |
$150K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
685 |
627 |
$150K |
| A4627 |
Spacer bag/reservoir |
3,965 |
3,397 |
$144K |
| B4162 |
Ef ped specmetabolic inherit |
365 |
299 |
$138K |
| T4528 |
Adult size pull-on xl |
869 |
624 |
$134K |
| B4103 |
Ef ped fluid and electrolyte |
1,244 |
1,111 |
$133K |
| T4531 |
Ped size pull-on sm/med |
851 |
746 |
$132K |
| A7521 |
Trach/laryn tube cuffed |
1,201 |
1,020 |
$131K |
| K0001 |
Standard wheelchair |
3,736 |
3,310 |
$129K |
| A9999 |
Dme supply or accessory, nos |
2,136 |
1,364 |
$125K |
| S8189 |
Trach supply noc |
4,538 |
3,577 |
$125K |
| B4224 |
Parenteral administration ki |
868 |
222 |
$122K |
| E0600 |
Suction pump portab hom modl |
2,091 |
1,868 |
$120K |
| A7002 |
Tubing used w suction pump |
8,910 |
8,176 |
$110K |
| B4158 |
Ef ped complete intact nut |
903 |
747 |
$107K |
| B4154 |
Ef spec metabolic noninherit |
254 |
212 |
$102K |
| K0738 |
Portable gas oxygen system |
2,915 |
2,823 |
$102K |
| E0562 |
Humidifier heated used w pap |
1,620 |
1,446 |
$98K |
| A4221 |
Supp non-insulin inf cath/wk |
3,572 |
1,657 |
$96K |
| A7032 |
Replacement nasal cushion |
2,611 |
2,261 |
$87K |
| A6212 |
Foam drg <=16 sq in w/border |
248 |
180 |
$86K |
| A4604 |
Tubing with heating element |
1,760 |
1,394 |
$71K |
| A4357 |
Bedside drainage bag |
809 |
599 |
$71K |
| A7005 |
Nondisposable nebulizer set |
3,138 |
2,807 |
$66K |
| A4385 |
Ost skn barrier sld ext wear |
678 |
497 |
$64K |
| E0619 |
Apnea monitor w recorder |
190 |
182 |
$61K |
| A4217 |
Sterile water/saline, 500 ml |
1,128 |
968 |
$60K |
| A6402 |
Sterile gauze <= 16 sq in |
4,840 |
4,171 |
$59K |
| S8120 |
O2 contents gas cubic ft |
2,153 |
1,245 |
$59K |
| K0195 |
Elevating whlchair leg rests |
3,982 |
3,552 |
$55K |
| E1226 |
Manual fully reclining back |
1,347 |
1,234 |
$53K |
| E0260 |
Hosp bed semi-electr w/ matt |
462 |
429 |
$42K |
| A6207 |
Contact layer >16<= 48 sq in |
217 |
190 |
$42K |
| B4220 |
Parenteral supply kit premix |
871 |
222 |
$41K |
| A7035 |
Pos airway press headgear |
1,708 |
1,487 |
$41K |
| T4524 |
Adult size brief/diaper xl |
309 |
260 |
$38K |
| E0603 |
Electric breast pump |
241 |
204 |
$36K |
| A4553 |
Nondisp underpads, all sizes |
2,553 |
2,270 |
$34K |
| L4361 |
Pneuma/vac walk boot pre ots |
104 |
86 |
$29K |
| A5120 |
Skin barrier, wipe or swab |
1,995 |
1,638 |
$29K |
| E0482 |
Cough stimulating device |
99 |
94 |
$27K |
| A7003 |
Nebulizer administration set |
7,330 |
6,539 |
$26K |
| A7046 |
Repl water chamber, pap dev |
1,817 |
1,597 |
$26K |
| A7007 |
Lg vol nebulizer disposable |
2,718 |
2,432 |
$25K |
| A7037 |
Pos airway pressure tubing |
957 |
896 |
$23K |
| A7038 |
Pos airway pressure filter |
3,904 |
3,341 |
$22K |
| A7525 |
Tracheostomy mask |
3,016 |
2,766 |
$20K |
| A7010 |
Disposable corrugated tubing |
1,172 |
1,100 |
$20K |
| A6453 |
Self-adher band w <3"/yd |
6,057 |
5,453 |
$19K |
| A4332 |
Lube sterile packet |
6,553 |
5,987 |
$19K |
| A4344 |
Cath indw foley 2 way silicn |
237 |
150 |
$18K |
| E0424 |
Stationary compressed gas 02 |
141 |
139 |
$17K |
| A7012 |
Nebulizer water collec devic |
2,215 |
2,005 |
$17K |
| K0003 |
Lightweight wheelchair |
329 |
314 |
$17K |
| E1392 |
Portable oxygen concentrator |
428 |
390 |
$16K |
| A4322 |
Irrigation syringe |
425 |
350 |
$14K |
| E0471 |
Rad w/backup non inv intrfc |
39 |
39 |
$12K |
| A4216 |
Sterile water/saline, 10 ml |
1,176 |
968 |
$11K |
| A7015 |
Aerosol mask used w nebulize |
4,221 |
3,663 |
$11K |
| E0978 |
W/c acc,saf belt pelv strap |
1,849 |
1,633 |
$10K |
| A4456 |
Adhesive remover, wipes |
605 |
541 |
$9K |
| E0565 |
Compressor air power source |
125 |
122 |
$7K |
| A7018 |
Water distilled w/nebulizer |
2,188 |
1,924 |
$7K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
13 |
12 |
$5K |
| A4425 |
Ost pch drain for barrier fl |
45 |
36 |
$5K |
| A4402 |
Lubricant per ounce |
184 |
167 |
$3K |
| L3908 |
Who cock-up nonmolde pre ots |
57 |
45 |
$3K |
| A4452 |
Waterproof tape |
97 |
88 |
$3K |
| T4537 |
Reusable underpad bed size |
1,375 |
983 |
$3K |
| E0973 |
W/ch access det adj armrest |
123 |
101 |
$3K |
| A7527 |
Trach/laryn tube plug/stop |
242 |
236 |
$2K |
| A4362 |
Solid skin barrier |
22 |
12 |
$2K |
| E0434 |
Portable liquid 02 |
35 |
24 |
$1K |
| A4450 |
Non-waterproof tape |
70 |
65 |
$485.46 |
| A4657 |
Syringe w/wo needle |
68 |
61 |
$131.90 |