| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
4,369 |
3,515 |
$3.98M |
| B4035 |
Enteral feed supp pump per d |
9,653 |
8,920 |
$1.54M |
| B4087 |
Gastro/jejuno tube, std |
26,036 |
10,965 |
$1.46M |
| B9002 |
Enter nutr inf pump any type |
15,257 |
14,609 |
$1.06M |
| E0465 |
Home vent invasive interface |
1,795 |
1,687 |
$896K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
4,664 |
4,294 |
$722K |
| E0445 |
Oximeter non-invasive |
9,769 |
9,360 |
$712K |
| B4149 |
Ef blenderized foods |
2,620 |
2,285 |
$652K |
| A4624 |
Tracheal suction tube |
5,273 |
4,532 |
$393K |
| E1390 |
Oxygen concentrator |
3,103 |
2,911 |
$357K |
| B4153 |
Ef hydrolyzed/amino acids |
553 |
502 |
$340K |
| B4088 |
Gastro/jejuno tube, low-pro |
4,502 |
4,134 |
$318K |
| E0424 |
Stationary compressed gas 02 |
1,834 |
1,722 |
$293K |
| E0439 |
Stationary liquid 02 |
1,900 |
1,847 |
$285K |
| T4534 |
Youth size pull-on |
2,817 |
2,529 |
$281K |
| E0431 |
Portable gaseous 02 |
7,855 |
7,475 |
$226K |
| T4530 |
Ped size brief/diaper lg |
2,958 |
2,667 |
$210K |
| A4554 |
Disposable underpads |
4,999 |
4,800 |
$168K |
| A9900 |
Supply/accessory/service |
1,040 |
824 |
$155K |
| T4522 |
Adult size brief/diaper med |
1,780 |
1,659 |
$151K |
| E0600 |
Suction pump portab hom modl |
3,854 |
3,557 |
$127K |
| B9998 |
Enteral supp not otherwise c |
411 |
369 |
$120K |
| A7002 |
Tubing used w suction pump |
4,521 |
4,295 |
$104K |
| A4927 |
Non-sterile gloves |
8,412 |
7,729 |
$104K |
| T4521 |
Adult size brief/diaper sm |
1,570 |
1,435 |
$102K |
| E0471 |
Rad w/backup non inv intrfc |
312 |
299 |
$85K |
| B4150 |
Ef complet w/intact nutrient |
673 |
634 |
$83K |
| B4155 |
Ef incomplete/modular |
1,515 |
1,422 |
$82K |
| A7010 |
Disposable corrugated tubing |
478 |
442 |
$81K |
| A7003 |
Nebulizer administration set |
4,179 |
3,961 |
$80K |
| A7508 |
Housing & integrated adhesiv |
2,312 |
2,099 |
$79K |
| A6402 |
Sterile gauze <= 16 sq in |
5,921 |
5,357 |
$68K |
| A4209 |
5+ cc sterile syringe&needle |
7,050 |
6,432 |
$68K |
| A4213 |
20+ cc syringe only |
3,970 |
3,717 |
$64K |
| A7526 |
Tracheostomy tube collar |
2,763 |
2,580 |
$64K |
| E0601 |
Cont airway pressure device |
1,044 |
1,011 |
$61K |
| E0619 |
Apnea monitor w recorder |
571 |
390 |
$60K |
| E0776 |
Iv pole |
2,735 |
2,614 |
$60K |
| E0565 |
Compressor air power source |
2,034 |
1,946 |
$56K |
| A4450 |
Non-waterproof tape |
3,264 |
2,857 |
$53K |
| E0466 |
Home vent non-invasive inter |
112 |
105 |
$53K |
| B4152 |
Ef calorie dense>/=1.5kcal |
358 |
325 |
$51K |
| A7520 |
Trach/laryn tube non-cuffed |
1,133 |
1,052 |
$51K |
| A6212 |
Foam drg <=16 sq in w/border |
448 |
371 |
$50K |
| A4629 |
Tracheostomy care kit |
1,010 |
956 |
$46K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
300 |
273 |
$39K |
| T4523 |
Adult size brief/diaper lg |
364 |
342 |
$37K |
| E1060 |
Wheelchair detachable arms |
587 |
563 |
$36K |
| A7521 |
Trach/laryn tube cuffed |
154 |
140 |
$36K |
| E0550 |
Humidif extens supple w ippb |
614 |
520 |
$34K |
| A4245 |
Alcohol wipes per box |
1,914 |
1,829 |
$30K |
| K0001 |
Standard wheelchair |
943 |
899 |
$28K |
| A4452 |
Waterproof tape |
1,352 |
1,284 |
$27K |
| E0570 |
Nebulizer with compression |
251 |
224 |
$26K |
| E0562 |
Humidifier heated used w pap |
2,029 |
1,947 |
$25K |
| A6257 |
Transparent film <= 16 sq in |
1,106 |
956 |
$25K |
| A4217 |
Sterile water/saline, 500 ml |
866 |
808 |
$23K |
| A7525 |
Tracheostomy mask |
1,312 |
1,236 |
$20K |
| A4216 |
Sterile water/saline, 10 ml |
1,225 |
1,150 |
$20K |
| A4332 |
Lube sterile packet |
1,775 |
1,596 |
$18K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
191 |
174 |
$17K |
| A4244 |
Alcohol or peroxide per pint |
3,178 |
2,948 |
$15K |
| A6216 |
Non-sterile gauze<=16 sq in |
1,526 |
1,442 |
$14K |
| A4206 |
1 cc sterile syringe&needle |
1,028 |
997 |
$14K |
| A4208 |
3 cc sterile syringe&needle |
1,512 |
1,471 |
$14K |
| A7012 |
Nebulizer water collec devic |
854 |
677 |
$12K |
| T4525 |
Adult size pull-on sm |
118 |
106 |
$10K |
| A7000 |
Disposable canister for pump |
1,125 |
1,029 |
$9K |
| E0470 |
Rad w/o backup non-inv intfc |
75 |
73 |
$8K |
| A4627 |
Spacer bag/reservoir |
317 |
317 |
$7K |
| A6258 |
Transparent film >16<=48 in |
115 |
110 |
$5K |
| A7007 |
Lg vol nebulizer disposable |
720 |
663 |
$5K |
| K0195 |
Elevating whlchair leg rests |
547 |
463 |
$3K |
| T4526 |
Adult size pull-on med |
13 |
12 |
$2K |
| T4532 |
Ped size pull-on lg |
15 |
13 |
$1K |
| T4533 |
Youth size brief/diaper |
14 |
14 |
$1K |
| E0630 |
Patient lift hydraulic |
27 |
24 |
$1K |
| A4402 |
Lubricant per ounce |
245 |
233 |
$397.97 |
| A7005 |
Nondisposable nebulizer set |
13 |
13 |
$127.06 |