| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
4,110 |
3,505 |
$3.01M |
| B4035 |
Enteral feed supp pump per d |
10,888 |
10,225 |
$2.23M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
8,532 |
7,917 |
$1.99M |
| E0465 |
Home vent invasive interface |
2,752 |
2,377 |
$1.61M |
| B4153 |
Ef hydrolyzed/amino acids |
1,873 |
1,545 |
$1.43M |
| B9002 |
Enter nutr inf pump any type |
14,945 |
13,859 |
$1.19M |
| E1390 |
Oxygen concentrator |
8,654 |
7,573 |
$1.06M |
| E0466 |
Home vent non-invasive inter |
1,624 |
1,370 |
$926K |
| B4149 |
Ef blenderized foods |
2,093 |
1,928 |
$903K |
| A4554 |
Disposable underpads |
12,291 |
11,182 |
$894K |
| A4624 |
Tracheal suction tube |
3,939 |
3,327 |
$734K |
| B4150 |
Ef complet w/intact nutrient |
3,557 |
2,909 |
$551K |
| E0431 |
Portable gaseous 02 |
9,090 |
8,157 |
$531K |
| T4534 |
Youth size pull-on |
3,942 |
3,665 |
$516K |
| T4522 |
Adult size brief/diaper med |
5,209 |
4,627 |
$512K |
| B4088 |
Gastro/jejuno tube, low-pro |
5,416 |
4,945 |
$494K |
| E0445 |
Oximeter non-invasive |
6,670 |
6,330 |
$494K |
| A9900 |
Supply/accessory/service |
9,703 |
8,172 |
$439K |
| T4521 |
Adult size brief/diaper sm |
4,283 |
3,871 |
$415K |
| A4927 |
Non-sterile gloves |
15,586 |
13,843 |
$301K |
| T4526 |
Adult size pull-on med |
2,203 |
1,960 |
$272K |
| A4213 |
20+ cc syringe only |
4,529 |
4,013 |
$249K |
| T4523 |
Adult size brief/diaper lg |
2,473 |
2,028 |
$238K |
| B4034 |
Enter feed supkit syr by day |
1,783 |
1,585 |
$193K |
| B4152 |
Ef calorie dense>/=1.5kcal |
882 |
767 |
$178K |
| A4629 |
Tracheostomy care kit |
2,275 |
1,964 |
$166K |
| T4530 |
Ped size brief/diaper lg |
1,697 |
1,598 |
$147K |
| A4244 |
Alcohol or peroxide per pint |
2,858 |
2,567 |
$126K |
| B9998 |
Enteral supp not otherwise c |
3,094 |
2,787 |
$125K |
| A6402 |
Sterile gauze <= 16 sq in |
5,560 |
4,428 |
$122K |
| S5199 |
Personal care item nos each |
1,303 |
764 |
$113K |
| T4525 |
Adult size pull-on sm |
977 |
946 |
$109K |
| A7003 |
Nebulizer administration set |
10,755 |
6,596 |
$109K |
| T4533 |
Youth size brief/diaper |
1,178 |
1,109 |
$107K |
| T4524 |
Adult size brief/diaper xl |
814 |
729 |
$96K |
| A4209 |
5+ cc sterile syringe&needle |
1,791 |
1,555 |
$92K |
| A4245 |
Alcohol wipes per box |
2,451 |
2,213 |
$87K |
| A7002 |
Tubing used w suction pump |
6,405 |
5,643 |
$84K |
| E0565 |
Compressor air power source |
3,439 |
2,925 |
$81K |
| B4155 |
Ef incomplete/modular |
1,090 |
990 |
$79K |
| E0601 |
Cont airway pressure device |
1,456 |
1,226 |
$78K |
| E0600 |
Suction pump portab hom modl |
2,881 |
2,524 |
$71K |
| A4450 |
Non-waterproof tape |
4,184 |
3,242 |
$69K |
| A7526 |
Tracheostomy tube collar |
3,819 |
3,349 |
$58K |
| A4402 |
Lubricant per ounce |
1,414 |
1,273 |
$44K |
| A4208 |
3 cc sterile syringe&needle |
348 |
327 |
$43K |
| A7520 |
Trach/laryn tube non-cuffed |
1,065 |
892 |
$41K |
| E0550 |
Humidif extens supple w ippb |
1,081 |
838 |
$39K |
| E0424 |
Stationary compressed gas 02 |
168 |
149 |
$34K |
| A4206 |
1 cc sterile syringe&needle |
243 |
232 |
$33K |
| A7507 |
Integrated filter & holder |
896 |
792 |
$33K |
| T4529 |
Ped size brief/diaper sm/med |
435 |
393 |
$31K |
| E0562 |
Humidifier heated used w pap |
1,461 |
1,258 |
$30K |
| T4527 |
Adult size pull-on lg |
195 |
187 |
$28K |
| A7508 |
Housing & integrated adhesiv |
584 |
525 |
$24K |
| T4532 |
Ped size pull-on lg |
242 |
229 |
$22K |
| E0618 |
Apnea monitor |
207 |
145 |
$21K |
| E1399 |
Durable medical equipment mi |
143 |
103 |
$18K |
| A4930 |
Sterile, gloves per pair |
892 |
809 |
$15K |
| E0570 |
Nebulizer with compression |
183 |
163 |
$12K |
| A7525 |
Tracheostomy mask |
4,333 |
2,019 |
$12K |
| A7015 |
Aerosol mask used w nebulize |
4,039 |
3,907 |
$11K |
| E0776 |
Iv pole |
1,002 |
971 |
$10K |
| A4353 |
Intermittent urinary cath |
14 |
12 |
$10K |
| A7012 |
Nebulizer water collec devic |
1,275 |
1,067 |
$8K |
| A7007 |
Lg vol nebulizer disposable |
1,954 |
931 |
$7K |
| A7010 |
Disposable corrugated tubing |
261 |
222 |
$7K |
| A7000 |
Disposable canister for pump |
935 |
838 |
$7K |
| A7521 |
Trach/laryn tube cuffed |
142 |
137 |
$5K |
| E0630 |
Patient lift hydraulic |
61 |
43 |
$4K |
| T4531 |
Ped size pull-on sm/med |
30 |
28 |
$3K |
| B4154 |
Ef spec metabolic noninherit |
12 |
12 |
$3K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
58 |
39 |
$1K |
| A6216 |
Non-sterile gauze<=16 sq in |
28 |
25 |
$92.00 |