| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4160 |
Ef ped caloric dense>/=0.7kc |
9,313 |
8,966 |
$813K |
| T4541 |
Large disposable underpad |
12,878 |
12,750 |
$650K |
| B4161 |
Ef ped hydrolyzed/amino acid |
3,492 |
3,359 |
$602K |
| B4154 |
Ef spec metabolic noninherit |
3,890 |
3,791 |
$584K |
| B4035 |
Enteral feed supp pump per d |
3,284 |
3,213 |
$359K |
| T4532 |
Ped size pull-on lg |
1,798 |
1,793 |
$297K |
| B9998 |
Enteral supp not otherwise c |
4,583 |
4,412 |
$293K |
| T4534 |
Youth size pull-on |
1,219 |
1,214 |
$226K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,984 |
1,948 |
$208K |
| T4523 |
Adult size brief/diaper lg |
1,909 |
1,902 |
$206K |
| A4322 |
Irrigation syringe |
2,912 |
2,863 |
$205K |
| T4535 |
Disposable liner/shield/pad |
4,916 |
4,780 |
$203K |
| E0603 |
Electric breast pump |
2,124 |
2,108 |
$191K |
| T4530 |
Ped size brief/diaper lg |
1,889 |
1,875 |
$173K |
| A4670 |
Automatic bp monitor, dial |
1,921 |
1,910 |
$168K |
| T4527 |
Adult size pull-on lg |
2,037 |
2,004 |
$134K |
| T4531 |
Ped size pull-on sm/med |
823 |
821 |
$114K |
| T4522 |
Adult size brief/diaper med |
1,644 |
1,637 |
$110K |
| T4526 |
Adult size pull-on med |
2,083 |
2,055 |
$107K |
| T4528 |
Adult size pull-on xl |
1,478 |
1,470 |
$100K |
| B4150 |
Ef complet w/intact nutrient |
1,222 |
1,196 |
$93K |
| A6250 |
Skin seal protect moisturizr |
5,009 |
4,949 |
$62K |
| A4335 |
Incontinence supply |
5,016 |
4,949 |
$49K |
| B4155 |
Ef incomplete/modular |
556 |
548 |
$41K |
| E0570 |
Nebulizer with compression |
782 |
643 |
$37K |
| E1399 |
Durable medical equipment mi |
4,693 |
4,485 |
$35K |
| A6402 |
Sterile gauze <= 16 sq in |
2,311 |
2,259 |
$33K |
| T4525 |
Adult size pull-on sm |
719 |
715 |
$31K |
| A4927 |
Non-sterile gloves |
1,464 |
1,436 |
$20K |
| A7000 |
Disposable canister for pump |
357 |
326 |
$20K |
| T4537 |
Reusable underpad bed size |
402 |
400 |
$19K |
| T4524 |
Adult size brief/diaper xl |
264 |
263 |
$19K |
| B9002 |
Enter nutr inf pump any type |
15 |
15 |
$10K |
| B4152 |
Ef calorie dense>/=1.5kcal |
27 |
27 |
$5K |
| K0001 |
Standard wheelchair |
206 |
191 |
$5K |
| A4657 |
Syringe w/wo needle |
346 |
309 |
$3K |
| A7002 |
Tubing used w suction pump |
38 |
38 |
$1K |
| A7005 |
Nondisposable nebulizer set |
60 |
59 |
$1K |
| T4521 |
Adult size brief/diaper sm |
13 |
13 |
$908.85 |
| A4628 |
Oropharyngeal suction cath |
37 |
37 |
$666.99 |
| A7015 |
Aerosol mask used w nebulize |
46 |
45 |
$46.11 |