| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
8,083 |
7,047 |
$6.55M |
| B4035 |
Enteral feed supp pump per d |
29,211 |
27,272 |
$6.47M |
| E0465 |
Home vent invasive interface |
8,417 |
8,123 |
$5.52M |
| E1390 |
Oxygen concentrator |
28,805 |
27,993 |
$4.15M |
| B4149 |
Ef blenderized foods |
8,354 |
8,018 |
$3.40M |
| B9002 |
Enter nutr inf pump any type |
44,624 |
43,786 |
$3.29M |
| E0445 |
Oximeter non-invasive |
33,251 |
32,390 |
$2.77M |
| B9998 |
Enteral supp not otherwise c |
30,712 |
28,320 |
$2.43M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
9,967 |
9,713 |
$2.34M |
| A4624 |
Tracheal suction tube |
9,023 |
8,234 |
$2.04M |
| B4088 |
Gastro/jejuno tube, low-pro |
14,215 |
13,933 |
$1.44M |
| E0431 |
Portable gaseous 02 |
30,394 |
29,415 |
$1.19M |
| A4629 |
Tracheostomy care kit |
10,988 |
10,407 |
$902K |
| B4153 |
Ef hydrolyzed/amino acids |
829 |
806 |
$748K |
| E0619 |
Apnea monitor w recorder |
4,946 |
4,603 |
$740K |
| E0471 |
Rad w/backup non inv intrfc |
1,800 |
1,761 |
$634K |
| B4150 |
Ef complet w/intact nutrient |
2,899 |
2,786 |
$578K |
| A4554 |
Disposable underpads |
12,779 |
12,373 |
$511K |
| E0570 |
Nebulizer with compression |
5,505 |
5,438 |
$500K |
| T4522 |
Adult size brief/diaper med |
4,279 |
4,071 |
$495K |
| A4927 |
Non-sterile gloves |
22,999 |
22,439 |
$393K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,632 |
1,574 |
$378K |
| E0466 |
Home vent non-invasive inter |
548 |
527 |
$368K |
| T4530 |
Ped size brief/diaper lg |
3,484 |
3,318 |
$340K |
| B4034 |
Enter feed supkit syr by day |
2,508 |
2,403 |
$286K |
| T4521 |
Adult size brief/diaper sm |
2,478 |
2,378 |
$266K |
| A7520 |
Trach/laryn tube non-cuffed |
5,208 |
4,850 |
$257K |
| A9900 |
Supply/accessory/service |
2,595 |
2,041 |
$253K |
| A7504 |
Tracheostoma hmes filter |
8,275 |
7,788 |
$214K |
| A6402 |
Sterile gauze <= 16 sq in |
13,793 |
13,304 |
$201K |
| E0600 |
Suction pump portab hom modl |
6,859 |
6,725 |
$193K |
| T4523 |
Adult size brief/diaper lg |
1,447 |
1,361 |
$187K |
| E0565 |
Compressor air power source |
6,850 |
6,687 |
$180K |
| T4532 |
Ped size pull-on lg |
1,371 |
1,325 |
$171K |
| A7002 |
Tubing used w suction pump |
9,367 |
9,217 |
$155K |
| A7521 |
Trach/laryn tube cuffed |
3,204 |
2,946 |
$153K |
| E1060 |
Wheelchair detachable arms |
1,883 |
1,859 |
$140K |
| E1150 |
Wheelchair standard w/ leg r |
2,719 |
2,664 |
$131K |
| A7003 |
Nebulizer administration set |
20,132 |
15,318 |
$126K |
| E0562 |
Humidifier heated used w pap |
4,029 |
3,905 |
$119K |
| E0601 |
Cont airway pressure device |
2,461 |
2,417 |
$114K |
| T4531 |
Ped size pull-on sm/med |
797 |
778 |
$94K |
| A6216 |
Non-sterile gauze<=16 sq in |
11,709 |
11,345 |
$89K |
| E0776 |
Iv pole |
8,904 |
8,680 |
$89K |
| B4155 |
Ef incomplete/modular |
2,070 |
2,010 |
$88K |
| T4525 |
Adult size pull-on sm |
506 |
501 |
$72K |
| T4534 |
Youth size pull-on |
465 |
457 |
$68K |
| T4533 |
Youth size brief/diaper |
528 |
510 |
$60K |
| A7525 |
Tracheostomy mask |
5,675 |
4,370 |
$56K |
| A4605 |
Trach suction cath close sys |
3,295 |
3,222 |
$53K |
| A4353 |
Intermittent urinary cath |
75 |
74 |
$49K |
| A6212 |
Foam drg <=16 sq in w/border |
210 |
193 |
$37K |
| A4244 |
Alcohol or peroxide per pint |
10,504 |
10,175 |
$36K |
| T4529 |
Ped size brief/diaper sm/med |
425 |
409 |
$36K |
| E0202 |
Phototherapy light w/ photom |
487 |
188 |
$31K |
| A7015 |
Aerosol mask used w nebulize |
5,654 |
5,550 |
$22K |
| A7000 |
Disposable canister for pump |
2,716 |
2,642 |
$20K |
| A7007 |
Lg vol nebulizer disposable |
2,490 |
1,824 |
$19K |
| T4526 |
Adult size pull-on med |
101 |
101 |
$16K |
| A4332 |
Lube sterile packet |
6,790 |
6,645 |
$16K |
| A4245 |
Alcohol wipes per box |
6,092 |
5,957 |
$11K |
| A7012 |
Nebulizer water collec devic |
2,163 |
2,089 |
$6K |
| B4087 |
Gastro/jejuno tube, std |
439 |
397 |
$5K |
| E0630 |
Patient lift hydraulic |
74 |
74 |
$4K |
| A7010 |
Disposable corrugated tubing |
354 |
340 |
$4K |
| L8501 |
Tracheostomy speaking valve |
24 |
24 |
$3K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
14 |
13 |
$2K |
| E0181 |
Press pad alternating w/ pum |
142 |
140 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
14 |
14 |
$1K |
| E0163 |
Commode chair with fixed arm |
12 |
12 |
$718.20 |
| E1392 |
Portable oxygen concentrator |
12 |
12 |
$253.99 |
| A4930 |
Sterile, gloves per pair |
38 |
37 |
$132.60 |