| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4230 |
Infus insulin pump non needl |
76,614 |
69,786 |
$11.95M |
| E0784 |
Ext amb infusn pump insulin |
12,697 |
12,014 |
$6.96M |
| B4154 |
Ef spec metabolic noninherit |
37,030 |
34,542 |
$5.25M |
| K0552 |
Sup/ext non-ins inf pump syr |
46,959 |
42,574 |
$1.45M |
| T4541 |
Large disposable underpad |
17,349 |
16,421 |
$1.17M |
| T4528 |
Adult size pull-on xl |
6,823 |
6,658 |
$1.16M |
| T4527 |
Adult size pull-on lg |
7,480 |
7,246 |
$1.04M |
| A6257 |
Transparent film <= 16 sq in |
69,024 |
62,539 |
$989K |
| E0601 |
Cont airway pressure device |
18,623 |
16,606 |
$981K |
| A4225 |
Sup/ext insulin inf pump syr |
30,507 |
27,459 |
$909K |
| T4526 |
Adult size pull-on med |
6,187 |
6,000 |
$877K |
| T4535 |
Disposable liner/shield/pad |
12,147 |
11,818 |
$576K |
| B4152 |
Ef calorie dense>/=1.5kcal |
5,659 |
5,185 |
$537K |
| B4150 |
Ef complet w/intact nutrient |
5,803 |
5,313 |
$408K |
| E1390 |
Oxygen concentrator |
3,301 |
2,970 |
$352K |
| E0562 |
Humidifier heated used w pap |
13,785 |
12,231 |
$331K |
| A7030 |
Cpap full face mask |
3,194 |
2,947 |
$297K |
| T4522 |
Adult size brief/diaper med |
2,791 |
2,566 |
$278K |
| A5120 |
Skin barrier, wipe or swab |
31,804 |
28,680 |
$238K |
| T4524 |
Adult size brief/diaper xl |
1,481 |
1,415 |
$221K |
| T4523 |
Adult size brief/diaper lg |
2,059 |
1,868 |
$214K |
| A4604 |
Tubing with heating element |
5,464 |
4,941 |
$172K |
| T4525 |
Adult size pull-on sm |
1,633 |
1,557 |
$167K |
| E0470 |
Rad w/o backup non-inv intfc |
1,176 |
1,038 |
$163K |
| A4927 |
Non-sterile gloves |
9,823 |
9,267 |
$132K |
| B4155 |
Ef incomplete/modular |
5,019 |
4,730 |
$122K |
| A7034 |
Nasal application device |
1,906 |
1,723 |
$118K |
| A7035 |
Pos airway press headgear |
4,545 |
4,139 |
$101K |
| T4530 |
Ped size brief/diaper lg |
799 |
776 |
$87K |
| A7031 |
Replacement facemask interfa |
2,424 |
2,267 |
$85K |
| K0001 |
Standard wheelchair |
3,308 |
2,937 |
$80K |
| A7032 |
Replacement nasal cushion |
2,051 |
1,834 |
$78K |
| E0570 |
Nebulizer with compression |
1,607 |
1,513 |
$55K |
| A7038 |
Pos airway pressure filter |
9,239 |
8,351 |
$52K |
| T4521 |
Adult size brief/diaper sm |
512 |
503 |
$41K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,293 |
1,227 |
$39K |
| A4670 |
Automatic bp monitor, dial |
565 |
523 |
$32K |
| E0143 |
Walker folding wheeled w/o s |
415 |
395 |
$23K |
| E0431 |
Portable gaseous 02 |
1,266 |
1,205 |
$22K |
| A7039 |
Filter, non disposable w pap |
2,438 |
2,198 |
$20K |
| E1392 |
Portable oxygen concentrator |
1,002 |
848 |
$19K |
| A7005 |
Nondisposable nebulizer set |
542 |
468 |
$9K |
| A4357 |
Bedside drainage bag |
653 |
419 |
$8K |
| A7033 |
Replacement nasal pillows |
247 |
224 |
$6K |
| E0156 |
Walker seat attachment |
712 |
682 |
$6K |
| A4253 |
Blood glucose/reagent strips |
726 |
712 |
$5K |
| A6402 |
Sterile gauze <= 16 sq in |
340 |
233 |
$5K |
| K0604 |
Repl batt lithium 3.6 v |
297 |
267 |
$3K |
| A4358 |
Urinary leg or abdomen bag |
300 |
165 |
$2K |
| A4456 |
Adhesive remover, wipes |
313 |
290 |
$2K |
| E0630 |
Patient lift hydraulic |
37 |
36 |
$2K |
| A7046 |
Repl water chamber, pap dev |
115 |
96 |
$1K |
| E0240 |
Bath/shower chair |
12 |
12 |
$1K |
| E0163 |
Commode chair with fixed arm |
15 |
14 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
385 |
339 |
$442.48 |
| E0245 |
Tub stool or bench |
12 |
12 |
$423.03 |
| A5063 |
Drain ostomy pouch w/flange |
12 |
12 |
$345.42 |
| A4259 |
Lancets per box |
494 |
491 |
$332.48 |
| A4217 |
Sterile water/saline, 500 ml |
21 |
12 |
$232.00 |
| K0195 |
Elevating whlchair leg rests |
77 |
75 |
$207.89 |
| A4450 |
Non-waterproof tape |
17 |
12 |
$76.48 |