| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
31,078 |
23,522 |
$7.77M |
| B4161 |
Ef ped hydrolyzed/amino acid |
8,593 |
7,141 |
$5.42M |
| B4149 |
Ef blenderized foods |
7,332 |
6,149 |
$2.89M |
| B4087 |
Gastro/jejuno tube, std |
16,820 |
16,409 |
$2.60M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
17,316 |
14,271 |
$2.50M |
| E0465 |
Home vent invasive interface |
2,233 |
1,391 |
$2.00M |
| B9002 |
Enter nutr inf pump any type |
11,197 |
10,526 |
$1.30M |
| A4222 |
Infusion supplies with pump |
2,184 |
1,447 |
$943K |
| B4100 |
Food thickener oral |
7,014 |
6,449 |
$893K |
| E0466 |
Home vent non-invasive inter |
693 |
606 |
$659K |
| B4088 |
Gastro/jejuno tube, low-pro |
5,168 |
5,090 |
$492K |
| B4154 |
Ef spec metabolic noninherit |
1,440 |
1,233 |
$455K |
| B4034 |
Enter feed supkit syr by day |
3,010 |
2,654 |
$422K |
| E1390 |
Oxygen concentrator |
3,019 |
2,870 |
$399K |
| B4036 |
Enteral feed sup kit grav by |
1,660 |
1,484 |
$338K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,460 |
2,098 |
$276K |
| B4155 |
Ef incomplete/modular |
3,125 |
2,582 |
$222K |
| B4150 |
Ef complet w/intact nutrient |
1,415 |
1,235 |
$198K |
| A4217 |
Sterile water/saline, 500 ml |
1,058 |
1,001 |
$159K |
| B4082 |
Enteral ng tubing w/o stylet |
3,536 |
3,356 |
$159K |
| A4605 |
Trach suction cath close sys |
529 |
500 |
$158K |
| E0482 |
Cough stimulating device |
283 |
270 |
$152K |
| B4158 |
Ef ped complete intact nut |
1,737 |
1,510 |
$138K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
589 |
555 |
$136K |
| A4221 |
Supp non-insulin inf cath/wk |
1,976 |
1,361 |
$135K |
| A4606 |
Oxygen probe used w oximeter |
1,572 |
1,506 |
$130K |
| A4624 |
Tracheal suction tube |
467 |
454 |
$126K |
| A7526 |
Tracheostomy tube collar |
1,000 |
962 |
$121K |
| B4103 |
Ef ped fluid and electrolyte |
1,622 |
1,333 |
$111K |
| E0600 |
Suction pump portab hom modl |
1,710 |
1,628 |
$106K |
| E0431 |
Portable gaseous 02 |
3,044 |
2,887 |
$90K |
| A7509 |
Heat & moisture exchange sys |
854 |
803 |
$70K |
| B4189 |
Parenteral sol amino acid & |
16 |
12 |
$59K |
| A6251 |
Absorpt drg <=16 sq in w/o b |
452 |
421 |
$54K |
| A7000 |
Disposable canister for pump |
1,693 |
1,654 |
$52K |
| B4224 |
Parenteral administration ki |
96 |
62 |
$48K |
| A6402 |
Sterile gauze <= 16 sq in |
1,024 |
971 |
$47K |
| A4216 |
Sterile water/saline, 10 ml |
1,322 |
1,213 |
$42K |
| B4153 |
Ef hydrolyzed/amino acids |
60 |
52 |
$41K |
| A7002 |
Tubing used w suction pump |
1,764 |
1,724 |
$36K |
| E0445 |
Oximeter non-invasive |
28 |
28 |
$25K |
| A7521 |
Trach/laryn tube cuffed |
377 |
357 |
$25K |
| E0471 |
Rad w/backup non inv intrfc |
46 |
40 |
$22K |
| E0781 |
External ambulatory infus pu |
65 |
62 |
$19K |
| A4628 |
Oropharyngeal suction cath |
1,125 |
1,102 |
$19K |
| A4927 |
Non-sterile gloves |
1,125 |
1,093 |
$19K |
| B4185 |
Pn soln nos 10 grams lipids |
34 |
24 |
$15K |
| A7520 |
Trach/laryn tube non-cuffed |
223 |
219 |
$13K |
| B4220 |
Parenteral supply kit premix |
79 |
50 |
$12K |
| A4627 |
Spacer bag/reservoir |
253 |
246 |
$7K |
| A6219 |
Gauze <= 16 sq in w/border |
49 |
45 |
$6K |
| S9342 |
Hit enteral pump diem |
66 |
63 |
$6K |
| A9900 |
Supply/accessory/service |
1,267 |
1,190 |
$5K |
| J3490 |
Drugs unclassified injection |
264 |
175 |
$4K |
| B4162 |
Ef ped specmetabolic inherit |
12 |
12 |
$4K |
| A7046 |
Repl water chamber, pap dev |
216 |
211 |
$4K |
| A7034 |
Nasal application device |
32 |
31 |
$3K |
| S8189 |
Trach supply noc |
67 |
61 |
$3K |
| A7004 |
Disposable nebulizer sml vol |
731 |
710 |
$3K |
| A4452 |
Waterproof tape |
443 |
425 |
$2K |
| A9999 |
Dme supply or accessory, nos |
314 |
306 |
$1K |
| A6453 |
Self-adher band w <3"/yd |
74 |
74 |
$1K |
| A6216 |
Non-sterile gauze<=16 sq in |
81 |
77 |
$711.19 |
| A7038 |
Pos airway pressure filter |
51 |
51 |
$486.89 |
| A7013 |
Disposable compressor filter |
288 |
284 |
$444.01 |
| A7015 |
Aerosol mask used w nebulize |
29 |
28 |
$60.88 |
| A4450 |
Non-waterproof tape |
42 |
42 |
$55.34 |