| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
2,099 |
1,608 |
$2.34M |
| B4035 |
Enteral feed supp pump per d |
4,860 |
4,441 |
$974K |
| E0465 |
Home vent invasive interface |
1,490 |
1,447 |
$930K |
| E0445 |
Oximeter non-invasive |
9,330 |
8,927 |
$733K |
| E1390 |
Oxygen concentrator |
3,853 |
3,715 |
$544K |
| B9002 |
Enter nutr inf pump any type |
7,782 |
7,555 |
$541K |
| E0424 |
Stationary compressed gas 02 |
2,936 |
2,840 |
$514K |
| B4149 |
Ef blenderized foods |
926 |
792 |
$332K |
| A4624 |
Tracheal suction tube |
4,195 |
3,179 |
$273K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,346 |
1,247 |
$268K |
| B4087 |
Gastro/jejuno tube, std |
9,687 |
4,454 |
$227K |
| E0466 |
Home vent non-invasive inter |
351 |
319 |
$203K |
| E0431 |
Portable gaseous 02 |
6,984 |
6,722 |
$196K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,022 |
1,906 |
$189K |
| A7521 |
Trach/laryn tube cuffed |
639 |
585 |
$155K |
| B9998 |
Enteral supp not otherwise c |
402 |
348 |
$129K |
| E0601 |
Cont airway pressure device |
1,643 |
1,585 |
$107K |
| A9900 |
Supply/accessory/service |
848 |
496 |
$96K |
| E0471 |
Rad w/backup non inv intrfc |
299 |
279 |
$93K |
| A7508 |
Housing & integrated adhesiv |
1,694 |
1,507 |
$86K |
| E0600 |
Suction pump portab hom modl |
2,862 |
2,681 |
$70K |
| T4534 |
Youth size pull-on |
503 |
444 |
$57K |
| A4554 |
Disposable underpads |
1,320 |
1,265 |
$55K |
| A4213 |
20+ cc syringe only |
3,009 |
2,794 |
$51K |
| A4629 |
Tracheostomy care kit |
612 |
575 |
$49K |
| A6402 |
Sterile gauze <= 16 sq in |
3,296 |
3,040 |
$48K |
| A4927 |
Non-sterile gloves |
3,854 |
3,517 |
$43K |
| E0570 |
Nebulizer with compression |
441 |
434 |
$39K |
| A4450 |
Non-waterproof tape |
1,843 |
1,740 |
$37K |
| A4209 |
5+ cc sterile syringe&needle |
3,647 |
3,285 |
$34K |
| K0001 |
Standard wheelchair |
1,043 |
1,031 |
$32K |
| E0550 |
Humidif extens supple w ippb |
888 |
838 |
$31K |
| A4216 |
Sterile water/saline, 10 ml |
1,045 |
976 |
$29K |
| A6257 |
Transparent film <= 16 sq in |
1,025 |
907 |
$27K |
| E0565 |
Compressor air power source |
1,092 |
1,048 |
$27K |
| A4452 |
Waterproof tape |
1,143 |
1,062 |
$27K |
| T4530 |
Ped size brief/diaper lg |
335 |
286 |
$26K |
| E0619 |
Apnea monitor w recorder |
162 |
156 |
$25K |
| A4245 |
Alcohol wipes per box |
1,447 |
1,373 |
$23K |
| A7526 |
Tracheostomy tube collar |
1,709 |
1,586 |
$23K |
| E0776 |
Iv pole |
2,031 |
1,977 |
$23K |
| A7003 |
Nebulizer administration set |
2,466 |
2,332 |
$20K |
| T4522 |
Adult size brief/diaper med |
180 |
168 |
$18K |
| E1060 |
Wheelchair detachable arms |
210 |
206 |
$14K |
| A4332 |
Lube sterile packet |
1,160 |
1,101 |
$12K |
| T4521 |
Adult size brief/diaper sm |
123 |
109 |
$11K |
| B4155 |
Ef incomplete/modular |
232 |
206 |
$11K |
| A4208 |
3 cc sterile syringe&needle |
1,565 |
1,480 |
$11K |
| E0562 |
Humidifier heated used w pap |
1,859 |
1,783 |
$11K |
| A7002 |
Tubing used w suction pump |
3,083 |
2,897 |
$9K |
| A6216 |
Non-sterile gauze<=16 sq in |
974 |
917 |
$8K |
| A7520 |
Trach/laryn tube non-cuffed |
138 |
116 |
$7K |
| A7000 |
Disposable canister for pump |
919 |
852 |
$6K |
| K0195 |
Elevating whlchair leg rests |
529 |
520 |
$6K |
| A4244 |
Alcohol or peroxide per pint |
1,622 |
1,482 |
$4K |
| A4206 |
1 cc sterile syringe&needle |
436 |
416 |
$3K |
| E0470 |
Rad w/o backup non-inv intfc |
27 |
24 |
$3K |
| A7525 |
Tracheostomy mask |
545 |
519 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
326 |
262 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
12 |
12 |
$750.31 |
| A4627 |
Spacer bag/reservoir |
31 |
31 |
$724.78 |
| A7007 |
Lg vol nebulizer disposable |
27 |
24 |
$230.92 |
| A7012 |
Nebulizer water collec devic |
19 |
13 |
$72.23 |