| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4160 |
Ef ped caloric dense>/=0.7kc |
6,633 |
6,410 |
$1.64M |
| A5120 |
Skin barrier, wipe or swab |
54,505 |
7,022 |
$1.15M |
| T4534 |
Youth size pull-on |
4,159 |
4,093 |
$621K |
| A4554 |
Disposable underpads |
9,905 |
9,743 |
$558K |
| A9900 |
Supply/accessory/service |
5,857 |
4,458 |
$515K |
| B4035 |
Enteral feed supp pump per d |
1,531 |
1,497 |
$342K |
| B4161 |
Ef ped hydrolyzed/amino acid |
256 |
230 |
$276K |
| T4530 |
Ped size brief/diaper lg |
2,562 |
2,499 |
$242K |
| A4927 |
Non-sterile gloves |
9,245 |
9,094 |
$189K |
| T4521 |
Adult size brief/diaper sm |
1,503 |
1,491 |
$183K |
| A4353 |
Intermittent urinary cath |
216 |
212 |
$135K |
| T4526 |
Adult size pull-on med |
462 |
460 |
$75K |
| B4034 |
Enter feed supkit syr by day |
524 |
513 |
$60K |
| B4088 |
Gastro/jejuno tube, low-pro |
569 |
562 |
$59K |
| B9002 |
Enter nutr inf pump any type |
758 |
735 |
$57K |
| A4213 |
20+ cc syringe only |
1,135 |
1,103 |
$54K |
| A4322 |
Irrigation syringe |
1,125 |
1,110 |
$53K |
| T4529 |
Ped size brief/diaper sm/med |
488 |
485 |
$51K |
| T4522 |
Adult size brief/diaper med |
322 |
319 |
$39K |
| T4532 |
Ped size pull-on lg |
273 |
263 |
$36K |
| A6402 |
Sterile gauze <= 16 sq in |
1,451 |
1,423 |
$31K |
| A4624 |
Tracheal suction tube |
67 |
49 |
$20K |
| B4087 |
Gastro/jejuno tube, std |
588 |
582 |
$16K |
| E0570 |
Nebulizer with compression |
173 |
161 |
$15K |
| T4527 |
Adult size pull-on lg |
24 |
24 |
$4K |
| B4150 |
Ef complet w/intact nutrient |
12 |
12 |
$3K |
| E0600 |
Suction pump portab hom modl |
102 |
102 |
$2K |
| A7005 |
Nondisposable nebulizer set |
204 |
194 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
88 |
87 |
$126.71 |