| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
19,939 |
18,438 |
$15.26M |
| B4035 |
Enteral feed supp pump per d |
53,254 |
50,681 |
$14.17M |
| E0465 |
Home vent invasive interface |
18,464 |
15,510 |
$12.83M |
| B9998 |
Enteral supp not otherwise c |
74,657 |
58,262 |
$6.60M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
20,841 |
19,533 |
$6.42M |
| E1390 |
Oxygen concentrator |
47,443 |
46,737 |
$5.51M |
| B4149 |
Ef blenderized foods |
12,444 |
11,350 |
$4.91M |
| E0466 |
Home vent non-invasive inter |
6,389 |
6,080 |
$4.84M |
| B4153 |
Ef hydrolyzed/amino acids |
3,325 |
3,079 |
$4.81M |
| A4606 |
Oxygen probe used w oximeter |
51,005 |
31,648 |
$3.71M |
| E0482 |
Cough stimulating device |
11,636 |
11,435 |
$3.00M |
| B4155 |
Ef incomplete/modular |
10,257 |
9,568 |
$2.89M |
| E1399 |
Durable medical equipment mi |
6,107 |
5,516 |
$2.67M |
| E0445 |
Oximeter non-invasive |
16,489 |
15,640 |
$2.32M |
| A4605 |
Trach suction cath close sys |
10,114 |
9,253 |
$2.24M |
| A4353 |
Intermittent urinary cath |
2,611 |
2,369 |
$1.73M |
| B4150 |
Ef complet w/intact nutrient |
5,610 |
5,176 |
$1.61M |
| A7000 |
Disposable canister for pump |
36,161 |
34,855 |
$1.51M |
| A4624 |
Tracheal suction tube |
11,755 |
10,868 |
$1.51M |
| A4554 |
Disposable underpads |
43,776 |
42,203 |
$1.28M |
| A4629 |
Tracheostomy care kit |
14,591 |
13,893 |
$1.25M |
| T4532 |
Ped size pull-on lg |
8,170 |
7,947 |
$1.19M |
| B9002 |
Enter nutr inf pump any type |
13,659 |
13,358 |
$1.10M |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,894 |
2,714 |
$1.09M |
| A6210 |
Foam drg >16<=48 sq in w/o b |
4,043 |
3,872 |
$1.01M |
| A7520 |
Trach/laryn tube non-cuffed |
12,503 |
11,397 |
$994K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
7,530 |
6,867 |
$988K |
| A7521 |
Trach/laryn tube cuffed |
7,611 |
6,832 |
$965K |
| E0431 |
Portable gaseous 02 |
47,595 |
46,940 |
$953K |
| T4522 |
Adult size brief/diaper med |
8,737 |
8,460 |
$893K |
| B4158 |
Ef ped complete intact nut |
3,551 |
3,300 |
$802K |
| A7526 |
Tracheostomy tube collar |
20,932 |
19,379 |
$786K |
| B4154 |
Ef spec metabolic noninherit |
1,269 |
1,123 |
$767K |
| B4103 |
Ef ped fluid and electrolyte |
4,105 |
3,894 |
$680K |
| E0471 |
Rad w/backup non inv intrfc |
1,963 |
1,922 |
$637K |
| A7002 |
Tubing used w suction pump |
35,954 |
34,581 |
$623K |
| B4034 |
Enter feed supkit syr by day |
6,853 |
6,490 |
$605K |
| T4533 |
Youth size brief/diaper |
5,547 |
5,400 |
$593K |
| E0481 |
Intrpulmnry percuss vent sys |
1,002 |
992 |
$556K |
| T4521 |
Adult size brief/diaper sm |
5,074 |
4,855 |
$501K |
| T4523 |
Adult size brief/diaper lg |
4,276 |
4,142 |
$456K |
| T4530 |
Ped size brief/diaper lg |
4,950 |
4,769 |
$439K |
| B4104 |
Additive for enteral formula |
4,735 |
4,473 |
$404K |
| T4531 |
Ped size pull-on sm/med |
3,381 |
3,296 |
$394K |
| T4526 |
Adult size pull-on med |
3,120 |
3,023 |
$341K |
| A4335 |
Incontinence supply |
57,855 |
55,468 |
$285K |
| E0600 |
Suction pump portab hom modl |
1,799 |
1,541 |
$276K |
| T4528 |
Adult size pull-on xl |
1,690 |
1,636 |
$255K |
| A4927 |
Non-sterile gloves |
37,284 |
35,963 |
$255K |
| A4351 |
Straight tip urine catheter |
1,481 |
1,344 |
$255K |
| A4322 |
Irrigation syringe |
18,052 |
17,306 |
$219K |
| T4527 |
Adult size pull-on lg |
1,621 |
1,557 |
$201K |
| E0601 |
Cont airway pressure device |
3,012 |
2,985 |
$196K |
| A6216 |
Non-sterile gauze<=16 sq in |
44,223 |
41,371 |
$196K |
| A6212 |
Foam drg <=16 sq in w/border |
969 |
895 |
$194K |
| A4628 |
Oropharyngeal suction cath |
31,871 |
30,556 |
$181K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
3,676 |
3,493 |
$179K |
| T4535 |
Disposable liner/shield/pad |
5,449 |
5,233 |
$141K |
| A4217 |
Sterile water/saline, 500 ml |
2,883 |
2,648 |
$103K |
| A7003 |
Nebulizer administration set |
31,970 |
30,968 |
$101K |
| E0776 |
Iv pole |
12,167 |
11,946 |
$85K |
| T4524 |
Adult size brief/diaper xl |
609 |
601 |
$82K |
| E0562 |
Humidifier heated used w pap |
4,794 |
4,729 |
$82K |
| A4402 |
Lubricant per ounce |
18,077 |
17,425 |
$80K |
| A4623 |
Tracheostomy inner cannula |
1,803 |
1,573 |
$77K |
| E0570 |
Nebulizer with compression |
1,196 |
1,169 |
$77K |
| A4481 |
Tracheostoma filter |
6,768 |
6,192 |
$73K |
| E0470 |
Rad w/o backup non-inv intfc |
426 |
421 |
$72K |
| B4100 |
Food thickener oral |
2,503 |
2,415 |
$61K |
| A4216 |
Sterile water/saline, 10 ml |
3,368 |
3,171 |
$56K |
| B4036 |
Enteral feed sup kit grav by |
459 |
428 |
$56K |
| K0003 |
Lightweight wheelchair |
947 |
917 |
$49K |
| E0565 |
Compressor air power source |
1,424 |
1,399 |
$42K |
| A4450 |
Non-waterproof tape |
19,015 |
18,524 |
$39K |
| E0260 |
Hosp bed semi-electr w/ matt |
497 |
488 |
$38K |
| A6257 |
Transparent film <= 16 sq in |
3,390 |
3,235 |
$36K |
| T4529 |
Ped size brief/diaper sm/med |
640 |
578 |
$27K |
| A4344 |
Cath indw foley 2 way silicn |
248 |
219 |
$26K |
| A7007 |
Lg vol nebulizer disposable |
5,574 |
5,308 |
$25K |
| A7012 |
Nebulizer water collec devic |
5,920 |
5,640 |
$25K |
| A7525 |
Tracheostomy mask |
10,453 |
7,019 |
$24K |
| A6250 |
Skin seal protect moisturizr |
4,985 |
4,729 |
$24K |
| A4357 |
Bedside drainage bag |
1,413 |
1,323 |
$21K |
| A7015 |
Aerosol mask used w nebulize |
15,675 |
15,352 |
$17K |
| A7010 |
Disposable corrugated tubing |
1,167 |
1,144 |
$16K |
| E0619 |
Apnea monitor w recorder |
94 |
91 |
$14K |
| A4253 |
Blood glucose/reagent strips |
852 |
798 |
$14K |
| A4452 |
Waterproof tape |
945 |
889 |
$13K |
| A6402 |
Sterile gauze <= 16 sq in |
1,228 |
1,179 |
$11K |
| A4338 |
Indwelling catheter latex |
166 |
156 |
$11K |
| A6260 |
Wound cleanser any type/size |
1,005 |
974 |
$9K |
| A4456 |
Adhesive remover, wipes |
945 |
903 |
$9K |
| A4371 |
Skin barrier powder per oz |
1,842 |
1,803 |
$8K |
| A4385 |
Ost skn barrier sld ext wear |
56 |
53 |
$7K |
| B4081 |
Enteral ng tubing w/ stylet |
98 |
90 |
$7K |
| B4082 |
Enteral ng tubing w/o stylet |
147 |
131 |
$7K |
| A5120 |
Skin barrier, wipe or swab |
713 |
675 |
$7K |
| A4483 |
Moisture exchanger |
85 |
75 |
$6K |
| A9900 |
Supply/accessory/service |
496 |
450 |
$6K |
| A4369 |
Skin barrier liquid per oz |
1,824 |
1,786 |
$5K |
| E0630 |
Patient lift hydraulic |
101 |
101 |
$5K |
| A4406 |
Pectin based ostomy paste |
174 |
163 |
$4K |
| A5200 |
Percutaneous catheter anchor |
98 |
85 |
$4K |
| A4250 |
Urine reagent strips/tablets |
507 |
482 |
$4K |
| A4259 |
Lancets per box |
536 |
527 |
$3K |
| A4310 |
Insert tray w/o bag/cath |
158 |
154 |
$3K |
| A6258 |
Transparent film >16<=48 in |
67 |
65 |
$3K |
| S8999 |
Resuscitation bag |
28 |
28 |
$3K |
| A4245 |
Alcohol wipes per box |
1,249 |
1,203 |
$2K |
| A7038 |
Pos airway pressure filter |
301 |
292 |
$1K |
| A7005 |
Nondisposable nebulizer set |
84 |
81 |
$1K |
| A6457 |
Tubular dressing |
25 |
25 |
$961.32 |
| L8501 |
Tracheostomy speaking valve |
13 |
12 |
$807.50 |
| A7037 |
Pos airway pressure tubing |
27 |
24 |
$487.22 |
| A7046 |
Repl water chamber, pap dev |
28 |
25 |
$312.90 |
| A4520 |
Incontinence garment anytype |
368 |
328 |
$133.01 |