| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
83,439 |
64,167 |
$65.08M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
101,502 |
80,787 |
$22.25M |
| B4035 |
Enteral feed supp pump per d |
97,216 |
74,991 |
$19.36M |
| B4149 |
Ef blenderized foods |
30,491 |
23,237 |
$9.67M |
| B4189 |
Parenteral sol amino acid & |
8,123 |
1,807 |
$7.32M |
| B4034 |
Enter feed supkit syr by day |
58,794 |
46,248 |
$6.40M |
| B4153 |
Ef hydrolyzed/amino acids |
8,977 |
6,540 |
$4.44M |
| J1569 |
Gammagard liquid injection |
274 |
169 |
$4.02M |
| B4154 |
Ef spec metabolic noninherit |
6,404 |
4,781 |
$3.05M |
| B9002 |
Enter nutr inf pump any type |
38,806 |
34,288 |
$2.86M |
| E0466 |
Home vent non-invasive inter |
5,987 |
5,460 |
$2.52M |
| B4158 |
Ef ped complete intact nut |
14,361 |
10,648 |
$2.26M |
| A4222 |
Infusion supplies with pump |
12,178 |
5,372 |
$2.08M |
| B4152 |
Ef calorie dense>/=1.5kcal |
16,982 |
12,848 |
$2.03M |
| B4150 |
Ef complet w/intact nutrient |
14,756 |
11,341 |
$1.72M |
| B4224 |
Parenteral administration ki |
23,472 |
3,146 |
$1.56M |
| A7030 |
Cpap full face mask |
19,077 |
17,617 |
$1.55M |
| E0603 |
Electric breast pump |
4,807 |
4,352 |
$1.47M |
| A4305 |
Drug delivery system >=50 ml |
5,537 |
1,915 |
$1.31M |
| B4036 |
Enteral feed sup kit grav by |
8,483 |
7,007 |
$1.23M |
| B4162 |
Ef ped specmetabolic inherit |
2,712 |
2,078 |
$1.14M |
| A4604 |
Tubing with heating element |
32,437 |
30,089 |
$1.12M |
| B4088 |
Gastro/jejuno tube, low-pro |
52,337 |
43,939 |
$1.01M |
| E0781 |
External ambulatory infus pu |
5,121 |
4,140 |
$943K |
| A7031 |
Replacement facemask interfa |
22,352 |
20,210 |
$888K |
| B4185 |
Pn soln nos 10 grams lipids |
13,257 |
2,893 |
$847K |
| A7034 |
Nasal application device |
14,283 |
13,322 |
$764K |
| E0601 |
Cont airway pressure device |
16,100 |
14,909 |
$684K |
| B4197 |
Parenteral sol 74-100 gm pro |
733 |
143 |
$599K |
| B4103 |
Ef ped fluid and electrolyte |
5,577 |
4,361 |
$591K |
| A4221 |
Supp non-insulin inf cath/wk |
25,147 |
11,426 |
$559K |
| B9004 |
Parenteral infus pump portab |
2,038 |
1,600 |
$533K |
| A7032 |
Replacement nasal cushion |
9,607 |
8,610 |
$526K |
| B4220 |
Parenteral supply kit premix |
14,660 |
3,139 |
$509K |
| B4155 |
Ef incomplete/modular |
12,985 |
10,213 |
$508K |
| B4100 |
Food thickener oral |
16,318 |
10,783 |
$507K |
| V5261 |
Hearing aid, digit, bin, bte |
522 |
450 |
$389K |
| E0776 |
Iv pole |
3,901 |
3,452 |
$364K |
| A7035 |
Pos airway press headgear |
18,956 |
17,623 |
$333K |
| J3490 |
Drugs unclassified injection |
3,457 |
1,083 |
$290K |
| A7033 |
Replacement nasal pillows |
6,596 |
5,956 |
$282K |
| E0470 |
Rad w/o backup non-inv intfc |
3,258 |
2,961 |
$275K |
| B4102 |
Ef adult fluids and electro |
2,973 |
2,379 |
$274K |
| E0562 |
Humidifier heated used w pap |
7,553 |
7,032 |
$273K |
| A7038 |
Pos airway pressure filter |
40,144 |
36,050 |
$252K |
| V5266 |
Battery for hearing device |
3,391 |
3,102 |
$204K |
| B4081 |
Enteral ng tubing w/ stylet |
7,869 |
6,053 |
$167K |
| J1459 |
Inj ivig privigen 500 mg |
15 |
13 |
$165K |
| A7046 |
Repl water chamber, pap dev |
13,894 |
12,890 |
$151K |
| V5264 |
Ear mold/insert |
2,866 |
2,645 |
$145K |
| 99601 |
|
571 |
322 |
$92K |
| B4157 |
Ef special metabolic inherit |
59 |
38 |
$63K |
| J3370 |
Vancomycin hcl injection |
1,463 |
521 |
$62K |
| J7030 |
Normal saline solution infus |
7,282 |
2,814 |
$48K |
| A6025 |
Silicone gel sheet, each |
1,222 |
888 |
$46K |
| V5257 |
Hearing aid, digit, mon, bte |
109 |
96 |
$39K |
| B4193 |
Parenteral sol 52-73 gm prot |
49 |
12 |
$36K |
| E0482 |
Cough stimulating device |
197 |
170 |
$34K |
| J2997 |
Alteplase recombinant |
72 |
51 |
$33K |
| J1650 |
Inj enoxaparin sodium |
2,283 |
559 |
$31K |
| E2402 |
Neg press wound therapy pump |
59 |
51 |
$23K |
| E0471 |
Rad w/backup non inv intrfc |
131 |
120 |
$20K |
| A4239 |
Non-adju cgm supply allow |
610 |
319 |
$19K |
| E1399 |
Durable medical equipment mi |
2,496 |
1,182 |
$17K |
| A7036 |
Pos airway press chinstrap |
1,276 |
1,200 |
$12K |
| B4159 |
Ef ped complete soy based |
63 |
38 |
$11K |
| A7037 |
Pos airway pressure tubing |
657 |
598 |
$8K |
| J1200 |
Diphenhydramine hcl injectio |
1,253 |
729 |
$8K |
| J0692 |
Cefepime hcl for injection |
113 |
36 |
$7K |
| V5267 |
Hearing aid sup/access/dev |
741 |
653 |
$7K |
| A6550 |
Neg pres wound ther drsg set |
42 |
26 |
$6K |
| A6504 |
Cmprsburngarment glove-wrist |
42 |
25 |
$5K |
| J0696 |
Ceftriaxone sodium injection |
188 |
74 |
$4K |
| 99602 |
Nursing care in home rn |
33 |
15 |
$4K |
| A6511 |
Compres burn garment panty |
36 |
24 |
$3K |
| A6512 |
Compres burn garment, noc |
62 |
40 |
$3K |
| A7039 |
Filter, non disposable w pap |
277 |
251 |
$2K |
| E0600 |
Suction pump portab hom modl |
85 |
74 |
$1K |
| J7120 |
Ringers lactate infusion |
50 |
26 |
$1K |
| J7050 |
Normal saline solution infus |
999 |
540 |
$1K |
| S9340 |
Hit enteral per diem |
1,335 |
1,218 |
$1K |
| J2260 |
Inj milrinone lactate / 5 mg |
37 |
12 |
$1K |
| J0690 |
Cefazolin sodium injection |
39 |
12 |
$984.28 |
| B4087 |
Gastro/jejuno tube, std |
84 |
63 |
$851.64 |
| J0171 |
Adrenalin epinephrine inject |
191 |
148 |
$427.38 |
| E2103 |
Non-adju cgm receiver/mon |
25 |
12 |
$391.08 |
| J2405 |
Ondansetron hcl injection |
29 |
13 |
$228.04 |
| J3475 |
Inj magnesium sulfate |
43 |
17 |
$113.84 |
| J1642 |
Inj heparin sodium per 10 u |
18 |
12 |
$44.26 |
| A7000 |
Disposable canister for pump |
20 |
14 |
$0.00 |