| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
3,434 |
3,056 |
$2.99M |
| B4035 |
Enteral feed supp pump per d |
10,147 |
8,715 |
$2.25M |
| E0465 |
Home vent invasive interface |
2,800 |
2,033 |
$2.22M |
| E0601 |
Cont airway pressure device |
30,408 |
29,283 |
$1.45M |
| E1390 |
Oxygen concentrator |
21,233 |
19,757 |
$1.34M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,722 |
2,407 |
$650K |
| A7030 |
Cpap full face mask |
8,187 |
7,858 |
$625K |
| B4153 |
Ef hydrolyzed/amino acids |
1,108 |
958 |
$543K |
| E0562 |
Humidifier heated used w pap |
6,164 |
5,815 |
$417K |
| A4554 |
Disposable underpads |
3,753 |
3,547 |
$397K |
| B9998 |
Enteral supp not otherwise c |
5,956 |
4,168 |
$344K |
| E0431 |
Portable gaseous 02 |
13,740 |
13,134 |
$238K |
| B4150 |
Ef complet w/intact nutrient |
1,860 |
1,634 |
$236K |
| A7034 |
Nasal application device |
6,274 |
6,000 |
$212K |
| A4217 |
Sterile water/saline, 500 ml |
2,819 |
2,490 |
$205K |
| A7520 |
Trach/laryn tube non-cuffed |
2,398 |
2,141 |
$199K |
| B9002 |
Enter nutr inf pump any type |
2,223 |
2,083 |
$192K |
| A7526 |
Tracheostomy tube collar |
2,862 |
2,631 |
$181K |
| A4624 |
Tracheal suction tube |
2,300 |
2,051 |
$178K |
| B4034 |
Enter feed supkit syr by day |
1,746 |
1,479 |
$175K |
| A4606 |
Oxygen probe used w oximeter |
3,852 |
3,619 |
$165K |
| E0466 |
Home vent non-invasive inter |
228 |
212 |
$158K |
| T4523 |
Adult size brief/diaper lg |
1,775 |
1,645 |
$150K |
| A4483 |
Moisture exchanger |
2,107 |
1,874 |
$142K |
| A7035 |
Pos airway press headgear |
12,007 |
11,491 |
$135K |
| E0470 |
Rad w/o backup non-inv intfc |
1,903 |
1,741 |
$134K |
| T4522 |
Adult size brief/diaper med |
1,787 |
1,678 |
$129K |
| A4604 |
Tubing with heating element |
5,420 |
5,132 |
$125K |
| B4155 |
Ef incomplete/modular |
984 |
908 |
$122K |
| B4152 |
Ef calorie dense>/=1.5kcal |
752 |
679 |
$105K |
| A7031 |
Replacement facemask interfa |
2,891 |
2,741 |
$101K |
| A7037 |
Pos airway pressure tubing |
9,079 |
8,728 |
$95K |
| E0570 |
Nebulizer with compression |
2,252 |
2,076 |
$93K |
| A7000 |
Disposable canister for pump |
4,951 |
4,635 |
$92K |
| A4605 |
Trach suction cath close sys |
820 |
750 |
$85K |
| E1399 |
Durable medical equipment mi |
8,320 |
3,883 |
$78K |
| A4927 |
Non-sterile gloves |
5,049 |
4,660 |
$73K |
| E0445 |
Oximeter non-invasive |
816 |
784 |
$72K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,410 |
1,334 |
$67K |
| E1392 |
Portable oxygen concentrator |
9,478 |
8,862 |
$65K |
| A4628 |
Oropharyngeal suction cath |
3,850 |
3,530 |
$62K |
| B4149 |
Ef blenderized foods |
231 |
218 |
$62K |
| T4527 |
Adult size pull-on lg |
752 |
695 |
$60K |
| A7038 |
Pos airway pressure filter |
10,406 |
9,920 |
$50K |
| T4524 |
Adult size brief/diaper xl |
432 |
424 |
$48K |
| B4154 |
Ef spec metabolic noninherit |
165 |
158 |
$47K |
| A7002 |
Tubing used w suction pump |
5,243 |
4,937 |
$43K |
| L4361 |
Pneuma/vac walk boot pre ots |
346 |
327 |
$38K |
| A4629 |
Tracheostomy care kit |
686 |
616 |
$37K |
| E0143 |
Walker folding wheeled w/o s |
919 |
867 |
$36K |
| A7046 |
Repl water chamber, pap dev |
5,638 |
5,372 |
$33K |
| E0600 |
Suction pump portab hom modl |
1,470 |
1,352 |
$29K |
| A4623 |
Tracheostomy inner cannula |
457 |
396 |
$27K |
| A4216 |
Sterile water/saline, 10 ml |
1,991 |
1,827 |
$26K |
| E0471 |
Rad w/backup non inv intrfc |
174 |
154 |
$26K |
| K0001 |
Standard wheelchair |
1,323 |
1,239 |
$23K |
| B4088 |
Gastro/jejuno tube, low-pro |
891 |
839 |
$20K |
| A4618 |
Breathing circuits |
766 |
665 |
$15K |
| A7003 |
Nebulizer administration set |
5,229 |
4,953 |
$14K |
| A7032 |
Replacement nasal cushion |
245 |
227 |
$10K |
| A7005 |
Nondisposable nebulizer set |
977 |
916 |
$9K |
| T4526 |
Adult size pull-on med |
133 |
120 |
$8K |
| K0003 |
Lightweight wheelchair |
165 |
161 |
$7K |
| A6402 |
Sterile gauze <= 16 sq in |
1,159 |
1,000 |
$7K |
| A7010 |
Disposable corrugated tubing |
552 |
512 |
$6K |
| T4535 |
Disposable liner/shield/pad |
337 |
319 |
$6K |
| A9999 |
Dme supply or accessory, nos |
1,276 |
726 |
$5K |
| E0776 |
Iv pole |
397 |
360 |
$5K |
| A7007 |
Lg vol nebulizer disposable |
984 |
855 |
$5K |
| L3908 |
Who cock-up nonmolde pre ots |
170 |
152 |
$5K |
| A7012 |
Nebulizer water collec devic |
650 |
556 |
$3K |
| A7525 |
Tracheostomy mask |
1,645 |
1,486 |
$3K |
| A4402 |
Lubricant per ounce |
626 |
601 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
3,111 |
2,920 |
$3K |
| A4649 |
Surgical supplies |
559 |
502 |
$3K |
| K0195 |
Elevating whlchair leg rests |
354 |
334 |
$3K |
| E0163 |
Commode chair with fixed arm |
73 |
69 |
$2K |
| A7521 |
Trach/laryn tube cuffed |
17 |
12 |
$2K |
| T4528 |
Adult size pull-on xl |
13 |
12 |
$938.13 |
| E0630 |
Patient lift hydraulic |
13 |
12 |
$735.01 |
| E0181 |
Press pad alternating w/ pum |
39 |
37 |
$602.79 |
| L1820 |
Ko elas w/ condyle pads & jo |
15 |
13 |
$553.02 |
| E0971 |
Wheelchair anti-tipping devi |
12 |
12 |
$68.77 |
| E0978 |
W/c acc,saf belt pelv strap |
28 |
26 |
$53.87 |