| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
14,685 |
9,897 |
$8.38M |
| B4161 |
Ef ped hydrolyzed/amino acid |
11,643 |
7,820 |
$6.26M |
| B4035 |
Enteral feed supp pump per d |
33,043 |
20,998 |
$3.73M |
| B9998 |
Enteral supp not otherwise c |
57,096 |
22,496 |
$2.70M |
| E1390 |
Oxygen concentrator |
33,843 |
30,825 |
$2.64M |
| A4483 |
Moisture exchanger |
10,591 |
7,437 |
$2.63M |
| E0466 |
Home vent non-invasive inter |
3,871 |
3,320 |
$2.60M |
| E0445 |
Oximeter non-invasive |
6,780 |
5,908 |
$2.01M |
| B4149 |
Ef blenderized foods |
7,577 |
4,875 |
$1.80M |
| A7521 |
Trach/laryn tube cuffed |
10,361 |
4,880 |
$1.78M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
11,310 |
8,017 |
$1.77M |
| Y2032 |
|
5,541 |
4,968 |
$1.69M |
| A4606 |
Oxygen probe used w oximeter |
50,062 |
18,742 |
$1.69M |
| A7520 |
Trach/laryn tube non-cuffed |
12,245 |
7,983 |
$1.64M |
| B4153 |
Ef hydrolyzed/amino acids |
2,682 |
1,558 |
$954K |
| E0431 |
Portable gaseous 02 |
28,421 |
25,428 |
$871K |
| B4088 |
Gastro/jejuno tube, low-pro |
9,180 |
7,110 |
$786K |
| A4217 |
Sterile water/saline, 500 ml |
14,654 |
10,385 |
$783K |
| E0471 |
Rad w/backup non inv intrfc |
2,985 |
2,611 |
$712K |
| A4624 |
Tracheal suction tube |
8,494 |
6,210 |
$692K |
| A7526 |
Tracheostomy tube collar |
15,907 |
11,393 |
$680K |
| A4605 |
Trach suction cath close sys |
5,638 |
4,136 |
$590K |
| E1399 |
Durable medical equipment mi |
2,319 |
658 |
$558K |
| T4522 |
Adult size brief/diaper med |
5,767 |
4,672 |
$536K |
| K0108 |
W/c component-accessory nos |
6,434 |
1,471 |
$528K |
| T4541 |
Large disposable underpad |
13,553 |
11,350 |
$450K |
| E0482 |
Cough stimulating device |
830 |
702 |
$425K |
| T4530 |
Ped size brief/diaper lg |
5,636 |
4,591 |
$419K |
| T2029 |
Special med equip, noswaiver |
951 |
888 |
$395K |
| B9002 |
Enter nutr inf pump any type |
2,105 |
1,811 |
$362K |
| A6402 |
Sterile gauze <= 16 sq in |
22,219 |
15,666 |
$300K |
| A4927 |
Non-sterile gloves |
23,789 |
18,587 |
$296K |
| T4523 |
Adult size brief/diaper lg |
3,155 |
2,609 |
$290K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
5,443 |
3,561 |
$288K |
| E1028 |
W/c manual swingaway |
2,938 |
1,648 |
$284K |
| A4930 |
Sterile, gloves per pair |
7,781 |
5,902 |
$283K |
| A7000 |
Disposable canister for pump |
19,619 |
15,017 |
$282K |
| A4629 |
Tracheostomy care kit |
4,843 |
3,631 |
$266K |
| B4150 |
Ef complet w/intact nutrient |
2,315 |
1,762 |
$264K |
| T4534 |
Youth size pull-on |
2,888 |
2,522 |
$225K |
| E0601 |
Cont airway pressure device |
3,576 |
3,380 |
$219K |
| T4521 |
Adult size brief/diaper sm |
2,718 |
2,125 |
$211K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
1,722 |
1,062 |
$196K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,124 |
2,864 |
$189K |
| A7002 |
Tubing used w suction pump |
20,328 |
15,003 |
$189K |
| E0600 |
Suction pump portab hom modl |
967 |
763 |
$182K |
| K0001 |
Standard wheelchair |
4,774 |
4,496 |
$179K |
| B4155 |
Ef incomplete/modular |
5,512 |
3,613 |
$178K |
| B4154 |
Ef spec metabolic noninherit |
947 |
495 |
$168K |
| A4351 |
Straight tip urine catheter |
1,430 |
1,226 |
$154K |
| A4322 |
Irrigation syringe |
17,435 |
13,015 |
$132K |
| B4152 |
Ef calorie dense>/=1.5kcal |
824 |
603 |
$112K |
| A4452 |
Waterproof tape |
9,995 |
7,687 |
$108K |
| T4525 |
Adult size pull-on sm |
974 |
850 |
$101K |
| T4526 |
Adult size pull-on med |
1,120 |
982 |
$100K |
| E0990 |
Wheelchair elevating leg res |
2,031 |
1,883 |
$99K |
| T4535 |
Disposable liner/shield/pad |
2,885 |
2,394 |
$98K |
| B4034 |
Enter feed supkit syr by day |
1,677 |
1,238 |
$92K |
| E0570 |
Nebulizer with compression |
1,535 |
1,393 |
$92K |
| E0973 |
W/ch access det adj armrest |
724 |
540 |
$88K |
| K0823 |
Pwc gp 2 std cap chair |
380 |
315 |
$83K |
| E0955 |
Cushioned headrest |
748 |
538 |
$81K |
| K0005 |
Ultralightweight wheelchair |
80 |
60 |
$74K |
| A4216 |
Sterile water/saline, 10 ml |
8,813 |
6,692 |
$73K |
| K0003 |
Lightweight wheelchair |
629 |
583 |
$71K |
| A7003 |
Nebulizer administration set |
21,902 |
10,531 |
$68K |
| B4100 |
Food thickener oral |
1,304 |
791 |
$61K |
| B4158 |
Ef ped complete intact nut |
400 |
263 |
$58K |
| T4533 |
Youth size brief/diaper |
829 |
649 |
$57K |
| T4524 |
Adult size brief/diaper xl |
558 |
460 |
$56K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
1,744 |
1,326 |
$55K |
| K0006 |
Heavy duty wheelchair |
578 |
530 |
$53K |
| E0562 |
Humidifier heated used w pap |
576 |
512 |
$53K |
| A7018 |
Water distilled w/nebulizer |
17,230 |
13,456 |
$51K |
| A4628 |
Oropharyngeal suction cath |
6,335 |
5,185 |
$43K |
| E0776 |
Iv pole |
1,021 |
825 |
$39K |
| A7007 |
Lg vol nebulizer disposable |
6,199 |
3,131 |
$39K |
| A7038 |
Pos airway pressure filter |
14,429 |
10,330 |
$38K |
| A4344 |
Cath indw foley 2 way silicn |
3,953 |
482 |
$36K |
| L8501 |
Tracheostomy speaking valve |
670 |
465 |
$33K |
| A6454 |
Self-adher band w>=3" <5"/yd |
7,021 |
5,343 |
$31K |
| K0739 |
Repair/svc dme non-oxygen eq |
975 |
708 |
$29K |
| A7035 |
Pos airway press headgear |
1,002 |
917 |
$25K |
| T4540 |
Reusable underpad chair size |
601 |
499 |
$24K |
| A4450 |
Non-waterproof tape |
9,087 |
6,575 |
$23K |
| E0971 |
Wheelchair anti-tipping devi |
395 |
299 |
$22K |
| A7525 |
Tracheostomy mask |
10,176 |
4,619 |
$22K |
| K0040 |
Adjustable angle footplate |
204 |
152 |
$19K |
| E0978 |
W/c acc,saf belt pelv strap |
645 |
490 |
$19K |
| E0565 |
Compressor air power source |
221 |
202 |
$19K |
| A4402 |
Lubricant per ounce |
7,360 |
5,629 |
$18K |
| E0143 |
Walker folding wheeled w/o s |
465 |
447 |
$16K |
| A6530 |
Compression stocking bk18-30 |
280 |
210 |
$16K |
| A7012 |
Nebulizer water collec devic |
5,628 |
2,905 |
$16K |
| E0960 |
W/c shoulder harness/straps |
213 |
158 |
$15K |
| A6212 |
Foam drg <=16 sq in w/border |
287 |
200 |
$14K |
| A4357 |
Bedside drainage bag |
2,705 |
806 |
$14K |
| B4082 |
Enteral ng tubing w/o stylet |
950 |
376 |
$13K |
| A4333 |
Urinary cath anchor device |
1,204 |
788 |
$12K |
| E0630 |
Patient lift hydraulic |
61 |
50 |
$11K |
| B4036 |
Enteral feed sup kit grav by |
210 |
133 |
$11K |
| A7015 |
Aerosol mask used w nebulize |
5,266 |
2,588 |
$11K |
| A5120 |
Skin barrier, wipe or swab |
2,568 |
1,562 |
$10K |
| A6257 |
Transparent film <= 16 sq in |
1,050 |
824 |
$10K |
| E0149 |
Heavy duty wheeled walker |
444 |
389 |
$8K |
| A7037 |
Pos airway pressure tubing |
384 |
361 |
$8K |
| A7034 |
Nasal application device |
192 |
161 |
$8K |
| A4247 |
Betadine/iodine swabs/wipes |
228 |
169 |
$7K |
| A4244 |
Alcohol or peroxide per pint |
6,556 |
4,804 |
$7K |
| E2617 |
Custom fab w/c back cushion |
19 |
12 |
$7K |
| T4527 |
Adult size pull-on lg |
56 |
50 |
$5K |
| A4670 |
Automatic bp monitor, dial |
114 |
113 |
$5K |
| T4531 |
Ped size pull-on sm/med |
65 |
58 |
$5K |
| A7030 |
Cpap full face mask |
60 |
53 |
$4K |
| A7046 |
Repl water chamber, pap dev |
955 |
326 |
$3K |
| E0156 |
Walker seat attachment |
310 |
297 |
$3K |
| E2607 |
Skin pro/pos wc cus wd <22in |
13 |
13 |
$3K |
| E0424 |
Stationary compressed gas 02 |
30 |
25 |
$2K |
| E0956 |
W/c lateral trunk/hip suppor |
15 |
12 |
$2K |
| E0245 |
Tub stool or bench |
49 |
48 |
$2K |
| E0135 |
Walker folding adjust/fixed |
24 |
24 |
$1K |
| A7005 |
Nondisposable nebulizer set |
57 |
55 |
$791.94 |
| A6216 |
Non-sterile gauze<=16 sq in |
81 |
53 |
$581.76 |
| E0163 |
Commode chair with fixed arm |
12 |
12 |
$522.61 |
| A7045 |
Repl exhalation port for pap |
360 |
204 |
$471.49 |
| B4081 |
Enteral ng tubing w/ stylet |
39 |
26 |
$411.90 |
| K0038 |
Leg strap each |
14 |
13 |
$304.09 |
| A4213 |
20+ cc syringe only |
128 |
116 |
$278.58 |
| E0100 |
Cane adjust/fixed with tip |
13 |
13 |
$124.31 |
| A4616 |
Tubing (oxygen) per foot |
569 |
377 |
$84.17 |
| A7020 |
Interface, cough stim device |
1,354 |
1,001 |
$80.04 |
| A4615 |
Cannula nasal |
48 |
45 |
$0.00 |
| A7010 |
Disposable corrugated tubing |
157 |
123 |
$0.00 |