| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
7,433 |
5,295 |
$3.68M |
| B4035 |
Enteral feed supp pump per d |
42,583 |
11,698 |
$2.51M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
11,421 |
7,407 |
$1.33M |
| B4149 |
Ef blenderized foods |
3,177 |
2,474 |
$1.14M |
| B4100 |
Food thickener oral |
9,623 |
7,251 |
$755K |
| B9998 |
Enteral supp not otherwise c |
14,756 |
8,295 |
$700K |
| T4534 |
Youth size pull-on |
6,232 |
5,632 |
$669K |
| B4088 |
Gastro/jejuno tube, low-pro |
5,415 |
4,887 |
$588K |
| E0570 |
Nebulizer with compression |
4,091 |
3,793 |
$500K |
| B4036 |
Enteral feed sup kit grav by |
12,343 |
3,266 |
$452K |
| T4533 |
Youth size brief/diaper |
3,869 |
3,537 |
$339K |
| T4541 |
Large disposable underpad |
6,876 |
6,484 |
$265K |
| T4529 |
Ped size brief/diaper sm/med |
2,726 |
2,441 |
$256K |
| B4150 |
Ef complet w/intact nutrient |
1,748 |
1,289 |
$233K |
| B4153 |
Ef hydrolyzed/amino acids |
415 |
267 |
$228K |
| B4034 |
Enter feed supkit syr by day |
2,457 |
1,142 |
$132K |
| B4155 |
Ef incomplete/modular |
2,939 |
2,402 |
$129K |
| T4530 |
Ped size brief/diaper lg |
1,115 |
913 |
$102K |
| B4152 |
Ef calorie dense>/=1.5kcal |
578 |
485 |
$92K |
| A4927 |
Non-sterile gloves |
7,484 |
6,898 |
$90K |
| A4221 |
Supp non-insulin inf cath/wk |
2,306 |
1,142 |
$51K |
| B4154 |
Ef spec metabolic noninherit |
154 |
125 |
$49K |
| T4537 |
Reusable underpad bed size |
435 |
423 |
$49K |
| T4531 |
Ped size pull-on sm/med |
459 |
435 |
$49K |
| T4535 |
Disposable liner/shield/pad |
1,276 |
1,125 |
$46K |
| T4532 |
Ped size pull-on lg |
303 |
287 |
$27K |
| B4158 |
Ef ped complete intact nut |
194 |
148 |
$19K |
| A7003 |
Nebulizer administration set |
8,655 |
4,145 |
$18K |
| E0776 |
Iv pole |
232 |
202 |
$16K |
| E0603 |
Electric breast pump |
74 |
50 |
$14K |
| A7015 |
Aerosol mask used w nebulize |
8,694 |
4,161 |
$14K |
| G0299 |
Hhs/hospice of rn ea 15 min |
124 |
35 |
$5K |
| E0605 |
Vaporizer room type |
240 |
232 |
$5K |
| T4522 |
Adult size brief/diaper med |
31 |
28 |
$3K |
| E0202 |
Phototherapy light w/ photom |
28 |
25 |
$2K |
| A4213 |
20+ cc syringe only |
147 |
116 |
$967.61 |
| A6402 |
Sterile gauze <= 16 sq in |
56 |
53 |
$282.40 |
| A4450 |
Non-waterproof tape |
23 |
23 |
$46.67 |