| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
1,066 |
910 |
$1.12M |
| B4035 |
Enteral feed supp pump per d |
2,831 |
2,396 |
$528K |
| E0465 |
Home vent invasive interface |
1,030 |
646 |
$512K |
| E0601 |
Cont airway pressure device |
8,981 |
8,700 |
$451K |
| E1390 |
Oxygen concentrator |
6,841 |
6,588 |
$441K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
856 |
742 |
$252K |
| A4554 |
Disposable underpads |
2,658 |
2,486 |
$204K |
| E0562 |
Humidifier heated used w pap |
2,896 |
2,755 |
$162K |
| A7030 |
Cpap full face mask |
2,081 |
2,001 |
$148K |
| B4150 |
Ef complet w/intact nutrient |
1,461 |
1,295 |
$140K |
| A7034 |
Nasal application device |
2,203 |
2,104 |
$106K |
| A4217 |
Sterile water/saline, 500 ml |
1,233 |
1,025 |
$100K |
| A7520 |
Trach/laryn tube non-cuffed |
906 |
826 |
$85K |
| A4606 |
Oxygen probe used w oximeter |
1,245 |
1,134 |
$72K |
| B4154 |
Ef spec metabolic noninherit |
171 |
158 |
$71K |
| B4152 |
Ef calorie dense>/=1.5kcal |
648 |
595 |
$69K |
| A7526 |
Tracheostomy tube collar |
1,332 |
1,198 |
$66K |
| E0431 |
Portable gaseous 02 |
3,127 |
3,009 |
$60K |
| B9998 |
Enteral supp not otherwise c |
1,441 |
1,115 |
$59K |
| A7035 |
Pos airway press headgear |
3,620 |
3,460 |
$57K |
| A4624 |
Tracheal suction tube |
886 |
784 |
$57K |
| B4153 |
Ef hydrolyzed/amino acids |
161 |
108 |
$55K |
| A7037 |
Pos airway pressure tubing |
2,722 |
2,624 |
$46K |
| A4604 |
Tubing with heating element |
1,532 |
1,441 |
$41K |
| T4522 |
Adult size brief/diaper med |
414 |
384 |
$37K |
| B4034 |
Enter feed supkit syr by day |
664 |
567 |
$35K |
| T4523 |
Adult size brief/diaper lg |
355 |
342 |
$34K |
| A4927 |
Non-sterile gloves |
2,640 |
2,428 |
$33K |
| A4216 |
Sterile water/saline, 10 ml |
853 |
768 |
$32K |
| A4483 |
Moisture exchanger |
411 |
341 |
$32K |
| A7000 |
Disposable canister for pump |
1,834 |
1,688 |
$29K |
| E0260 |
Hosp bed semi-electr w/ matt |
527 |
500 |
$29K |
| E1392 |
Portable oxygen concentrator |
2,668 |
2,558 |
$28K |
| B9002 |
Enter nutr inf pump any type |
314 |
299 |
$27K |
| T4526 |
Adult size pull-on med |
285 |
279 |
$22K |
| E1399 |
Durable medical equipment mi |
1,192 |
676 |
$20K |
| A4628 |
Oropharyngeal suction cath |
1,207 |
1,074 |
$19K |
| A7038 |
Pos airway pressure filter |
3,210 |
3,004 |
$16K |
| E0445 |
Oximeter non-invasive |
110 |
110 |
$16K |
| B4088 |
Gastro/jejuno tube, low-pro |
674 |
626 |
$15K |
| A7002 |
Tubing used w suction pump |
1,975 |
1,825 |
$14K |
| A4605 |
Trach suction cath close sys |
112 |
88 |
$12K |
| A7031 |
Replacement facemask interfa |
451 |
410 |
$12K |
| A4623 |
Tracheostomy inner cannula |
97 |
77 |
$10K |
| E0600 |
Suction pump portab hom modl |
514 |
449 |
$10K |
| E0570 |
Nebulizer with compression |
359 |
353 |
$10K |
| A7046 |
Repl water chamber, pap dev |
1,685 |
1,579 |
$9K |
| E0470 |
Rad w/o backup non-inv intfc |
140 |
135 |
$9K |
| A4629 |
Tracheostomy care kit |
141 |
125 |
$8K |
| A6402 |
Sterile gauze <= 16 sq in |
558 |
484 |
$6K |
| A7003 |
Nebulizer administration set |
1,729 |
1,564 |
$5K |
| E0143 |
Walker folding wheeled w/o s |
105 |
103 |
$4K |
| K0001 |
Standard wheelchair |
70 |
67 |
$2K |
| T4524 |
Adult size brief/diaper xl |
31 |
24 |
$2K |
| L3908 |
Who cock-up nonmolde pre ots |
59 |
53 |
$2K |
| A7525 |
Tracheostomy mask |
574 |
511 |
$2K |
| A4618 |
Breathing circuits |
106 |
82 |
$1K |
| A9999 |
Dme supply or accessory, nos |
721 |
486 |
$1K |
| A7032 |
Replacement nasal cushion |
44 |
38 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
598 |
542 |
$574.13 |
| A4649 |
Surgical supplies |
39 |
36 |
$556.54 |
| A7033 |
Replacement nasal pillows |
38 |
38 |
$527.75 |
| A7007 |
Lg vol nebulizer disposable |
113 |
86 |
$366.48 |
| E0163 |
Commode chair with fixed arm |
13 |
13 |
$235.80 |
| K0195 |
Elevating whlchair leg rests |
13 |
12 |
$121.80 |
| E0971 |
Wheelchair anti-tipping devi |
27 |
25 |
$83.70 |
| A7005 |
Nondisposable nebulizer set |
15 |
15 |
$73.04 |
| A7012 |
Nebulizer water collec devic |
16 |
13 |
$59.12 |
| A4402 |
Lubricant per ounce |
14 |
13 |
$51.03 |