| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
3,353 |
2,977 |
$5.01M |
| B4161 |
Ef ped hydrolyzed/amino acid |
5,883 |
5,086 |
$4.42M |
| B4035 |
Enteral feed supp pump per d |
14,416 |
13,399 |
$3.47M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
7,491 |
6,642 |
$2.69M |
| B4088 |
Gastro/jejuno tube, low-pro |
11,550 |
10,330 |
$2.21M |
| B4149 |
Ef blenderized foods |
6,510 |
5,940 |
$2.21M |
| E0466 |
Home vent non-invasive inter |
2,530 |
2,414 |
$2.17M |
| B9998 |
Enteral supp not otherwise c |
15,456 |
13,866 |
$1.94M |
| E0445 |
Oximeter non-invasive |
3,975 |
3,402 |
$1.49M |
| A4606 |
Oxygen probe used w oximeter |
13,982 |
8,990 |
$1.41M |
| E1390 |
Oxygen concentrator |
14,355 |
13,964 |
$1.10M |
| T4534 |
Youth size pull-on |
6,830 |
6,503 |
$1.00M |
| E0600 |
Suction pump portab hom modl |
12,012 |
11,770 |
$585K |
| A7520 |
Trach/laryn tube non-cuffed |
3,194 |
2,629 |
$551K |
| A9999 |
Dme supply or accessory, nos |
6,631 |
5,568 |
$472K |
| A4927 |
Non-sterile gloves |
13,215 |
12,669 |
$395K |
| T4522 |
Adult size brief/diaper med |
3,092 |
2,944 |
$369K |
| B4153 |
Ef hydrolyzed/amino acids |
669 |
590 |
$365K |
| K0738 |
Portable gas oxygen system |
10,809 |
10,598 |
$364K |
| T4530 |
Ped size brief/diaper lg |
3,744 |
3,568 |
$347K |
| B9002 |
Enter nutr inf pump any type |
6,251 |
5,946 |
$344K |
| A7526 |
Tracheostomy tube collar |
3,145 |
2,934 |
$288K |
| A4624 |
Tracheal suction tube |
2,238 |
2,063 |
$281K |
| A6212 |
Foam drg <=16 sq in w/border |
967 |
801 |
$271K |
| A4554 |
Disposable underpads |
6,434 |
6,174 |
$245K |
| E0482 |
Cough stimulating device |
605 |
539 |
$236K |
| T4535 |
Disposable liner/shield/pad |
4,793 |
4,586 |
$229K |
| B4155 |
Ef incomplete/modular |
1,507 |
1,364 |
$227K |
| A5200 |
Percutaneous catheter anchor |
2,214 |
2,097 |
$216K |
| A9286 |
Any hygienic item, device |
9,996 |
9,618 |
$205K |
| B4104 |
Additive for enteral formula |
2,249 |
2,021 |
$197K |
| T4521 |
Adult size brief/diaper sm |
1,887 |
1,774 |
$188K |
| A7507 |
Integrated filter & holder |
1,359 |
1,219 |
$161K |
| B4103 |
Ef ped fluid and electrolyte |
2,139 |
1,701 |
$158K |
| A4483 |
Moisture exchanger |
1,826 |
1,605 |
$150K |
| A4605 |
Trach suction cath close sys |
1,637 |
1,473 |
$139K |
| T4532 |
Ped size pull-on lg |
1,258 |
1,191 |
$129K |
| A6402 |
Sterile gauze <= 16 sq in |
8,231 |
7,740 |
$120K |
| A4553 |
Nondisp underpads, all sizes |
2,376 |
2,287 |
$119K |
| B4100 |
Food thickener oral |
1,352 |
1,015 |
$109K |
| A4216 |
Sterile water/saline, 10 ml |
3,587 |
3,262 |
$109K |
| B4150 |
Ef complet w/intact nutrient |
755 |
654 |
$106K |
| A7046 |
Repl water chamber, pap dev |
6,625 |
5,293 |
$100K |
| B4154 |
Ef spec metabolic noninherit |
257 |
231 |
$95K |
| B4158 |
Ef ped complete intact nut |
478 |
415 |
$89K |
| A7000 |
Disposable canister for pump |
6,152 |
5,755 |
$87K |
| A4628 |
Oropharyngeal suction cath |
5,904 |
5,473 |
$85K |
| A4452 |
Waterproof tape |
10,842 |
10,068 |
$79K |
| T4523 |
Adult size brief/diaper lg |
497 |
452 |
$78K |
| A4344 |
Cath indw foley 2 way silicn |
900 |
760 |
$75K |
| A6250 |
Skin seal protect moisturizr |
6,691 |
6,334 |
$68K |
| T4526 |
Adult size pull-on med |
679 |
654 |
$64K |
| A4322 |
Irrigation syringe |
1,381 |
1,250 |
$57K |
| A4481 |
Tracheostoma filter |
185 |
163 |
$42K |
| A6211 |
Foam drg > 48 sq in w/o brdr |
416 |
380 |
$42K |
| B4036 |
Enteral feed sup kit grav by |
983 |
918 |
$42K |
| A5120 |
Skin barrier, wipe or swab |
5,105 |
4,777 |
$42K |
| A4351 |
Straight tip urine catheter |
327 |
303 |
$39K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
583 |
550 |
$39K |
| T4533 |
Youth size brief/diaper |
312 |
290 |
$30K |
| A4629 |
Tracheostomy care kit |
1,268 |
1,179 |
$28K |
| A7034 |
Nasal application device |
505 |
442 |
$28K |
| L8501 |
Tracheostomy speaking valve |
305 |
286 |
$25K |
| A4456 |
Adhesive remover, wipes |
2,863 |
2,672 |
$24K |
| E0601 |
Cont airway pressure device |
456 |
354 |
$24K |
| A7020 |
Interface, cough stim device |
1,061 |
863 |
$24K |
| A6453 |
Self-adher band w <3"/yd |
3,478 |
3,273 |
$20K |
| A7037 |
Pos airway pressure tubing |
1,062 |
942 |
$18K |
| A7035 |
Pos airway press headgear |
783 |
658 |
$14K |
| A7003 |
Nebulizer administration set |
3,980 |
3,690 |
$12K |
| S8186 |
Swivel adaptor |
760 |
613 |
$12K |
| A4245 |
Alcohol wipes per box |
1,390 |
1,337 |
$12K |
| A9901 |
Delivery/set up/dispensing |
304 |
268 |
$10K |
| A7018 |
Water distilled w/nebulizer |
825 |
787 |
$9K |
| A4627 |
Spacer bag/reservoir |
241 |
234 |
$9K |
| A4409 |
Ost skn barr convex <=4 sq i |
54 |
38 |
$7K |
| A6257 |
Transparent film <= 16 sq in |
313 |
254 |
$6K |
| A7007 |
Lg vol nebulizer disposable |
568 |
451 |
$5K |
| A4402 |
Lubricant per ounce |
605 |
561 |
$5K |
| A4332 |
Lube sterile packet |
2,663 |
2,519 |
$4K |
| A4425 |
Ost pch drain for barrier fl |
59 |
39 |
$4K |
| A7038 |
Pos airway pressure filter |
1,588 |
1,383 |
$4K |
| A4450 |
Non-waterproof tape |
919 |
858 |
$4K |
| A7012 |
Nebulizer water collec devic |
560 |
450 |
$3K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
68 |
62 |
$3K |
| A7001 |
Nondisposable pump canister |
134 |
123 |
$3K |
| A7002 |
Tubing used w suction pump |
398 |
368 |
$3K |
| A4385 |
Ost skn barrier sld ext wear |
26 |
24 |
$3K |
| B4152 |
Ef calorie dense>/=1.5kcal |
16 |
12 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
1,916 |
1,721 |
$2K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
13 |
12 |
$2K |
| A7525 |
Tracheostomy mask |
461 |
373 |
$2K |
| A4371 |
Skin barrier powder per oz |
313 |
291 |
$1K |
| A4244 |
Alcohol or peroxide per pint |
927 |
846 |
$1K |
| A4455 |
Adhesive remover per ounce |
108 |
106 |
$574.97 |
| E0776 |
Iv pole |
38 |
36 |
$483.53 |