| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
104,799 |
100,361 |
$14.71M |
| B4161 |
Ef ped hydrolyzed/amino acid |
16,171 |
15,459 |
$11.58M |
| B4035 |
Enteral feed supp pump per d |
31,324 |
28,021 |
$7.70M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
25,578 |
24,432 |
$6.48M |
| B9998 |
Enteral supp not otherwise c |
50,645 |
36,022 |
$4.57M |
| B4149 |
Ef blenderized foods |
7,261 |
6,742 |
$2.69M |
| B4155 |
Ef incomplete/modular |
7,406 |
7,021 |
$2.47M |
| B4153 |
Ef hydrolyzed/amino acids |
1,676 |
1,609 |
$2.33M |
| T4534 |
Youth size pull-on |
12,776 |
11,821 |
$1.35M |
| A4606 |
Oxygen probe used w oximeter |
10,975 |
10,090 |
$1.20M |
| B9002 |
Enter nutr inf pump any type |
1,839 |
1,773 |
$1.20M |
| B4150 |
Ef complet w/intact nutrient |
4,402 |
4,190 |
$1.15M |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,562 |
3,431 |
$1.10M |
| A4554 |
Disposable underpads |
37,384 |
34,753 |
$1.05M |
| B4154 |
Ef spec metabolic noninherit |
1,470 |
1,408 |
$1.02M |
| A4353 |
Intermittent urinary cath |
1,428 |
1,209 |
$827K |
| E0445 |
Oximeter non-invasive |
904 |
839 |
$751K |
| B4158 |
Ef ped complete intact nut |
3,487 |
3,350 |
$721K |
| A4322 |
Irrigation syringe |
30,158 |
26,002 |
$691K |
| E1390 |
Oxygen concentrator |
6,444 |
5,848 |
$671K |
| T4522 |
Adult size brief/diaper med |
7,307 |
6,684 |
$667K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
3,303 |
2,997 |
$535K |
| T4530 |
Ped size brief/diaper lg |
5,742 |
5,168 |
$470K |
| T4533 |
Youth size brief/diaper |
4,735 |
4,423 |
$450K |
| B4103 |
Ef ped fluid and electrolyte |
2,707 |
2,567 |
$450K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
3,244 |
2,988 |
$423K |
| A7000 |
Disposable canister for pump |
10,471 |
8,828 |
$407K |
| E0465 |
Home vent invasive interface |
585 |
453 |
$404K |
| T4521 |
Adult size brief/diaper sm |
4,137 |
3,915 |
$385K |
| T4532 |
Ped size pull-on lg |
2,848 |
2,682 |
$382K |
| B4104 |
Additive for enteral formula |
3,946 |
3,525 |
$342K |
| A9900 |
Supply/accessory/service |
14,787 |
10,377 |
$315K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
471 |
346 |
$302K |
| T4526 |
Adult size pull-on med |
2,770 |
2,658 |
$291K |
| T4523 |
Adult size brief/diaper lg |
3,121 |
2,929 |
$281K |
| A4335 |
Incontinence supply |
52,053 |
48,106 |
$280K |
| E0466 |
Home vent non-invasive inter |
393 |
367 |
$258K |
| A6402 |
Sterile gauze <= 16 sq in |
21,889 |
19,933 |
$257K |
| A6530 |
Compression stocking bk18-30 |
1,855 |
1,366 |
$253K |
| B4034 |
Enter feed supkit syr by day |
2,364 |
2,093 |
$228K |
| A4351 |
Straight tip urine catheter |
1,397 |
1,214 |
$228K |
| T1999 |
Noc retail items andsupplies |
56,073 |
27,907 |
$220K |
| E0482 |
Cough stimulating device |
880 |
840 |
$188K |
| A4624 |
Tracheal suction tube |
1,738 |
1,580 |
$186K |
| A4927 |
Non-sterile gloves |
25,591 |
23,726 |
$174K |
| B4036 |
Enteral feed sup kit grav by |
1,120 |
1,029 |
$164K |
| A7002 |
Tubing used w suction pump |
9,598 |
9,030 |
$144K |
| A6212 |
Foam drg <=16 sq in w/border |
674 |
632 |
$142K |
| T4527 |
Adult size pull-on lg |
1,093 |
997 |
$120K |
| B4100 |
Food thickener oral |
2,621 |
2,538 |
$114K |
| T4535 |
Disposable liner/shield/pad |
4,627 |
4,275 |
$110K |
| E0431 |
Portable gaseous 02 |
5,746 |
5,198 |
$104K |
| A4452 |
Waterproof tape |
6,776 |
5,879 |
$102K |
| E0570 |
Nebulizer with compression |
1,068 |
1,013 |
$99K |
| A6257 |
Transparent film <= 16 sq in |
3,287 |
2,726 |
$96K |
| A4670 |
Automatic bp monitor, dial |
1,941 |
1,814 |
$95K |
| T4525 |
Adult size pull-on sm |
1,099 |
963 |
$88K |
| T4524 |
Adult size brief/diaper xl |
747 |
719 |
$87K |
| B4162 |
Ef ped specmetabolic inherit |
94 |
77 |
$78K |
| E0776 |
Iv pole |
1,261 |
1,225 |
$78K |
| A4483 |
Moisture exchanger |
1,025 |
810 |
$76K |
| A4217 |
Sterile water/saline, 500 ml |
2,201 |
1,854 |
$74K |
| A4450 |
Non-waterproof tape |
14,158 |
12,534 |
$70K |
| A6250 |
Skin seal protect moisturizr |
12,474 |
11,626 |
$70K |
| A4605 |
Trach suction cath close sys |
376 |
304 |
$69K |
| T4531 |
Ped size pull-on sm/med |
993 |
587 |
$65K |
| E0600 |
Suction pump portab hom modl |
209 |
195 |
$64K |
| B4082 |
Enteral ng tubing w/o stylet |
1,129 |
1,025 |
$58K |
| A4628 |
Oropharyngeal suction cath |
10,125 |
9,367 |
$58K |
| E0601 |
Cont airway pressure device |
781 |
755 |
$58K |
| B4081 |
Enteral ng tubing w/ stylet |
982 |
904 |
$57K |
| T4528 |
Adult size pull-on xl |
336 |
324 |
$56K |
| A7520 |
Trach/laryn tube non-cuffed |
974 |
895 |
$55K |
| A4629 |
Tracheostomy care kit |
670 |
639 |
$53K |
| A7526 |
Tracheostomy tube collar |
1,629 |
1,306 |
$52K |
| A7003 |
Nebulizer administration set |
14,156 |
13,569 |
$47K |
| A4344 |
Cath indw foley 2 way silicn |
408 |
362 |
$41K |
| A6457 |
Tubular dressing |
1,363 |
1,230 |
$40K |
| A5061 |
Pouch drainable w barrier at |
447 |
411 |
$37K |
| A4216 |
Sterile water/saline, 10 ml |
1,871 |
1,594 |
$36K |
| E1399 |
Durable medical equipment mi |
88 |
70 |
$35K |
| E0562 |
Humidifier heated used w pap |
1,896 |
1,737 |
$32K |
| A4357 |
Bedside drainage bag |
1,166 |
910 |
$32K |
| A7030 |
Cpap full face mask |
297 |
283 |
$23K |
| A7037 |
Pos airway pressure tubing |
1,103 |
1,025 |
$22K |
| A4402 |
Lubricant per ounce |
4,260 |
3,923 |
$22K |
| E0470 |
Rad w/o backup non-inv intfc |
117 |
113 |
$20K |
| A4213 |
20+ cc syringe only |
5,121 |
4,764 |
$17K |
| A7046 |
Repl water chamber, pap dev |
1,300 |
1,041 |
$17K |
| A7015 |
Aerosol mask used w nebulize |
12,595 |
12,143 |
$15K |
| A4456 |
Adhesive remover, wipes |
1,453 |
1,268 |
$14K |
| A4250 |
Urine reagent strips/tablets |
1,177 |
1,091 |
$9K |
| A4369 |
Skin barrier liquid per oz |
670 |
630 |
$8K |
| A7032 |
Replacement nasal cushion |
267 |
249 |
$8K |
| A7038 |
Pos airway pressure filter |
1,753 |
1,575 |
$8K |
| A7031 |
Replacement facemask interfa |
245 |
231 |
$7K |
| A4371 |
Skin barrier powder per oz |
941 |
898 |
$7K |
| A4406 |
Pectin based ostomy paste |
520 |
484 |
$6K |
| A5120 |
Skin barrier, wipe or swab |
1,000 |
764 |
$6K |
| T4529 |
Ped size brief/diaper sm/med |
145 |
133 |
$6K |
| A4310 |
Insert tray w/o bag/cath |
73 |
64 |
$4K |
| A7521 |
Trach/laryn tube cuffed |
106 |
81 |
$4K |
| A4385 |
Ost skn barrier sld ext wear |
27 |
24 |
$2K |
| A6216 |
Non-sterile gauze<=16 sq in |
186 |
178 |
$2K |
| A4245 |
Alcohol wipes per box |
983 |
929 |
$1K |
| A7010 |
Disposable corrugated tubing |
129 |
113 |
$1K |
| A7525 |
Tracheostomy mask |
589 |
541 |
$901.07 |
| A7005 |
Nondisposable nebulizer set |
55 |
51 |
$875.73 |
| A6258 |
Transparent film >16<=48 in |
12 |
12 |
$820.99 |
| A7034 |
Nasal application device |
12 |
12 |
$589.46 |
| A7013 |
Disposable compressor filter |
219 |
208 |
$169.33 |
| A9270 |
Non-covered item or service |
1,706 |
1,552 |
$0.00 |
| A4520 |
Incontinence garment anytype |
2,057 |
1,492 |
$0.00 |