| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
23,890 |
13,995 |
$30.19M |
| B4149 |
Ef blenderized foods |
46,683 |
32,088 |
$24.54M |
| B4035 |
Enteral feed supp pump per d |
66,090 |
61,635 |
$19.52M |
| B4161 |
Ef ped hydrolyzed/amino acid |
30,424 |
23,195 |
$16.90M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
44,425 |
34,282 |
$10.99M |
| B9998 |
Enteral supp not otherwise c |
97,242 |
60,373 |
$10.19M |
| B4153 |
Ef hydrolyzed/amino acids |
5,293 |
4,227 |
$7.68M |
| B4088 |
Gastro/jejuno tube, low-pro |
48,792 |
42,130 |
$6.60M |
| E0466 |
Home vent non-invasive inter |
4,652 |
3,690 |
$6.29M |
| A4606 |
Oxygen probe used w oximeter |
34,976 |
28,727 |
$4.81M |
| A4217 |
Sterile water/saline, 500 ml |
27,521 |
21,226 |
$3.89M |
| E0445 |
Oximeter non-invasive |
17,999 |
15,929 |
$3.83M |
| B9002 |
Enter nutr inf pump any type |
22,852 |
20,869 |
$2.81M |
| B4155 |
Ef incomplete/modular |
10,992 |
8,702 |
$2.71M |
| A7521 |
Trach/laryn tube cuffed |
6,820 |
4,944 |
$2.39M |
| B4150 |
Ef complet w/intact nutrient |
8,395 |
6,503 |
$2.34M |
| T4530 |
Ped size brief/diaper lg |
13,609 |
12,483 |
$2.21M |
| A4624 |
Tracheal suction tube |
11,312 |
9,647 |
$2.06M |
| A4351 |
Straight tip urine catheter |
8,393 |
7,593 |
$1.81M |
| A4605 |
Trach suction cath close sys |
4,021 |
3,664 |
$1.66M |
| T4521 |
Adult size brief/diaper sm |
11,703 |
10,010 |
$1.64M |
| A7520 |
Trach/laryn tube non-cuffed |
8,795 |
6,821 |
$1.41M |
| A7507 |
Integrated filter & holder |
9,192 |
7,788 |
$1.31M |
| T4534 |
Youth size pull-on |
9,347 |
8,368 |
$1.20M |
| B4152 |
Ef calorie dense>/=1.5kcal |
4,563 |
3,654 |
$1.20M |
| E0482 |
Cough stimulating device |
1,974 |
1,623 |
$1.18M |
| T4522 |
Adult size brief/diaper med |
8,927 |
7,721 |
$1.15M |
| A7526 |
Tracheostomy tube collar |
12,706 |
11,489 |
$1.13M |
| B4154 |
Ef spec metabolic noninherit |
1,957 |
1,474 |
$1.05M |
| A4927 |
Non-sterile gloves |
38,545 |
33,701 |
$1.03M |
| E1390 |
Oxygen concentrator |
19,433 |
16,921 |
$1.01M |
| T4541 |
Large disposable underpad |
21,673 |
19,848 |
$984K |
| A6212 |
Foam drg <=16 sq in w/border |
3,520 |
2,916 |
$977K |
| A9999 |
Dme supply or accessory, nos |
53,636 |
24,507 |
$977K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
4,875 |
4,264 |
$938K |
| A4352 |
Coude tip urinary catheter |
1,265 |
1,113 |
$915K |
| B4034 |
Enter feed supkit syr by day |
6,597 |
6,477 |
$857K |
| E1399 |
Durable medical equipment mi |
3,235 |
3,046 |
$820K |
| T4535 |
Disposable liner/shield/pad |
9,900 |
8,628 |
$644K |
| A4483 |
Moisture exchanger |
4,744 |
3,944 |
$556K |
| T4531 |
Ped size pull-on sm/med |
4,548 |
4,203 |
$555K |
| T4533 |
Youth size brief/diaper |
3,656 |
3,320 |
$555K |
| E0600 |
Suction pump portab hom modl |
5,468 |
4,516 |
$501K |
| E0431 |
Portable gaseous 02 |
25,185 |
22,598 |
$479K |
| B4158 |
Ef ped complete intact nut |
2,876 |
2,202 |
$468K |
| E0471 |
Rad w/backup non inv intrfc |
1,668 |
1,559 |
$451K |
| A7046 |
Repl water chamber, pap dev |
13,231 |
11,849 |
$449K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
1,282 |
1,044 |
$437K |
| A7001 |
Nondisposable pump canister |
13,519 |
12,356 |
$419K |
| T4523 |
Adult size brief/diaper lg |
3,199 |
2,736 |
$411K |
| T4529 |
Ped size brief/diaper sm/med |
2,673 |
2,423 |
$410K |
| A4657 |
Syringe w/wo needle |
45,801 |
38,509 |
$383K |
| A4353 |
Intermittent urinary cath |
475 |
395 |
$378K |
| A4453 |
Rec cath any transanal, each |
875 |
619 |
$361K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
7,758 |
6,765 |
$357K |
| A4322 |
Irrigation syringe |
9,820 |
6,764 |
$338K |
| A4385 |
Ost skn barrier sld ext wear |
2,812 |
2,326 |
$317K |
| B4036 |
Enteral feed sup kit grav by |
1,668 |
1,598 |
$309K |
| A4628 |
Oropharyngeal suction cath |
18,239 |
16,027 |
$304K |
| K0462 |
Temporary replacement eqpmnt |
2,256 |
2,131 |
$277K |
| T4526 |
Adult size pull-on med |
2,084 |
1,896 |
$267K |
| L8501 |
Tracheostomy speaking valve |
1,531 |
1,395 |
$239K |
| T4525 |
Adult size pull-on sm |
1,862 |
1,687 |
$221K |
| A7008 |
Disposable nebulizer prefill |
1,919 |
1,643 |
$215K |
| A7034 |
Nasal application device |
2,763 |
2,511 |
$190K |
| E0562 |
Humidifier heated used w pap |
5,569 |
5,258 |
$183K |
| T4532 |
Ped size pull-on lg |
1,009 |
929 |
$178K |
| A7005 |
Nondisposable nebulizer set |
3,689 |
3,440 |
$171K |
| A4213 |
20+ cc syringe only |
6,773 |
6,212 |
$170K |
| B4162 |
Ef ped specmetabolic inherit |
485 |
340 |
$169K |
| A4218 |
Sterile saline or water |
9,500 |
8,166 |
$163K |
| A7003 |
Nebulizer administration set |
15,515 |
14,090 |
$153K |
| E0776 |
Iv pole |
1,422 |
1,264 |
$146K |
| A7002 |
Tubing used w suction pump |
19,953 |
18,059 |
$143K |
| A4357 |
Bedside drainage bag |
1,970 |
1,618 |
$140K |
| A7000 |
Disposable canister for pump |
8,816 |
8,137 |
$137K |
| S8189 |
Trach supply noc |
12,720 |
9,753 |
$135K |
| A4332 |
Lube sterile packet |
6,579 |
6,046 |
$113K |
| A4456 |
Adhesive remover, wipes |
5,859 |
5,147 |
$100K |
| A7020 |
Interface, cough stim device |
5,247 |
5,055 |
$95K |
| E0601 |
Cont airway pressure device |
1,830 |
1,702 |
$90K |
| A4452 |
Waterproof tape |
12,357 |
11,246 |
$90K |
| A4362 |
Solid skin barrier |
1,199 |
954 |
$88K |
| T4527 |
Adult size pull-on lg |
637 |
590 |
$82K |
| A7035 |
Pos airway press headgear |
2,753 |
2,409 |
$74K |
| A4421 |
Ostomy supply misc |
475 |
334 |
$73K |
| A4344 |
Cath indw foley 2 way silicn |
339 |
299 |
$65K |
| A5120 |
Skin barrier, wipe or swab |
4,993 |
4,463 |
$63K |
| A4409 |
Ost skn barr convex <=4 sq i |
574 |
429 |
$60K |
| A4623 |
Tracheostomy inner cannula |
283 |
240 |
$60K |
| A6402 |
Sterile gauze <= 16 sq in |
4,233 |
3,735 |
$49K |
| E0570 |
Nebulizer with compression |
635 |
612 |
$45K |
| A4245 |
Alcohol wipes per box |
8,297 |
7,875 |
$45K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
457 |
347 |
$43K |
| A4425 |
Ost pch drain for barrier fl |
720 |
490 |
$43K |
| A7015 |
Aerosol mask used w nebulize |
8,894 |
8,026 |
$43K |
| A4604 |
Tubing with heating element |
714 |
668 |
$41K |
| A4629 |
Tracheostomy care kit |
759 |
657 |
$30K |
| E0443 |
Portable 02 contents, gas |
610 |
598 |
$28K |
| A4627 |
Spacer bag/reservoir |
873 |
815 |
$28K |
| A4358 |
Urinary leg or abdomen bag |
567 |
449 |
$27K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
125 |
99 |
$26K |
| T4542 |
Small disposable underpad |
1,348 |
1,243 |
$24K |
| A7030 |
Cpap full face mask |
221 |
194 |
$23K |
| T4524 |
Adult size brief/diaper xl |
107 |
99 |
$23K |
| A6258 |
Transparent film >16<=48 in |
293 |
232 |
$23K |
| E0619 |
Apnea monitor w recorder |
109 |
99 |
$22K |
| S8186 |
Swivel adaptor |
2,751 |
2,560 |
$21K |
| A7037 |
Pos airway pressure tubing |
1,838 |
1,568 |
$20K |
| A5056 |
1 pc ost pouch w filter |
167 |
123 |
$19K |
| B4100 |
Food thickener oral |
625 |
496 |
$18K |
| A4209 |
5+ cc sterile syringe&needle |
2,663 |
2,290 |
$18K |
| A7038 |
Pos airway pressure filter |
4,098 |
3,847 |
$18K |
| A7525 |
Tracheostomy mask |
5,688 |
5,080 |
$17K |
| A4618 |
Breathing circuits |
1,170 |
1,044 |
$16K |
| E0565 |
Compressor air power source |
207 |
182 |
$15K |
| S8999 |
Resuscitation bag |
449 |
381 |
$15K |
| A4930 |
Sterile, gloves per pair |
329 |
278 |
$14K |
| S8120 |
O2 contents gas cubic ft |
764 |
531 |
$14K |
| A7039 |
Filter, non disposable w pap |
3,324 |
3,054 |
$13K |
| B4082 |
Enteral ng tubing w/o stylet |
348 |
258 |
$12K |
| A7013 |
Disposable compressor filter |
6,704 |
6,281 |
$11K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
94 |
82 |
$8K |
| A6257 |
Transparent film <= 16 sq in |
327 |
268 |
$7K |
| A4402 |
Lubricant per ounce |
844 |
760 |
$6K |
| K0003 |
Lightweight wheelchair |
119 |
111 |
$6K |
| B4103 |
Ef ped fluid and electrolyte |
326 |
268 |
$5K |
| A4335 |
Incontinence supply |
105 |
99 |
$5K |
| A4371 |
Skin barrier powder per oz |
477 |
432 |
$4K |
| K0739 |
Repair/svc dme non-oxygen eq |
81 |
80 |
$4K |
| A4554 |
Disposable underpads |
189 |
164 |
$3K |
| A4458 |
Reusable enema bag |
722 |
625 |
$3K |
| A5063 |
Drain ostomy pouch w/flange |
87 |
68 |
$3K |
| A4250 |
Urine reagent strips/tablets |
212 |
187 |
$2K |
| A4407 |
Ext wear ost skn barr <=4sq" |
13 |
12 |
$2K |
| A7045 |
Repl exhalation port for pap |
193 |
170 |
$2K |
| A6216 |
Non-sterile gauze<=16 sq in |
95 |
88 |
$1K |
| A4450 |
Non-waterproof tape |
139 |
112 |
$894.89 |
| E0978 |
W/c acc,saf belt pelv strap |
256 |
252 |
$841.51 |
| E0990 |
Wheelchair elevating leg res |
74 |
71 |
$680.08 |
| A6260 |
Wound cleanser any type/size |
46 |
41 |
$636.45 |
| E0190 |
Positioning cushion |
33 |
27 |
$567.13 |
| A4394 |
Ostomy pouch liq deodorant |
47 |
39 |
$484.09 |
| A4244 |
Alcohol or peroxide per pint |
120 |
99 |
$472.78 |
| A4206 |
1 cc sterile syringe&needle |
117 |
100 |
$417.64 |
| E0971 |
Wheelchair anti-tipping devi |
90 |
87 |
$322.37 |
| A7527 |
Trach/laryn tube plug/stop |
48 |
43 |
$283.78 |
| A4333 |
Urinary cath anchor device |
15 |
13 |
$129.96 |
| A7014 |
Compressor nondispos filter |
14 |
13 |
$30.19 |
| S8210 |
Mucus trap |
13 |
12 |
$17.34 |
| A4626 |
Tracheostomy cleaning brush |
26 |
24 |
$2.50 |
| T1999 |
Noc retail items andsupplies |
483 |
156 |
$0.00 |
| S9999 |
Sales tax |
415 |
350 |
$0.00 |