| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Ef ped hydrolyzed/amino acid |
5,966 |
4,971 |
$5.11M |
| B4035 |
Enteral feed supp pump per d |
14,170 |
13,124 |
$3.41M |
| A9900 |
Supply/accessory/service |
22,432 |
18,684 |
$2.26M |
| E1390 |
Oxygen concentrator |
14,071 |
13,535 |
$2.13M |
| E0465 |
Home vent invasive interface |
3,031 |
2,948 |
$2.04M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
8,463 |
8,077 |
$1.98M |
| A4624 |
Tracheal suction tube |
10,317 |
9,300 |
$1.66M |
| B9002 |
Enter nutr inf pump any type |
16,973 |
16,558 |
$1.33M |
| E0445 |
Oximeter non-invasive |
12,692 |
12,378 |
$1.22M |
| T4534 |
Youth size pull-on |
7,785 |
7,509 |
$1.15M |
| B9998 |
Enteral supp not otherwise c |
15,431 |
13,160 |
$1.03M |
| B4036 |
Enteral feed sup kit grav by |
6,393 |
5,927 |
$1.01M |
| A4554 |
Disposable underpads |
15,904 |
15,139 |
$804K |
| B4149 |
Ef blenderized foods |
1,618 |
1,510 |
$687K |
| B4153 |
Ef hydrolyzed/amino acids |
772 |
722 |
$667K |
| E0431 |
Portable gaseous 02 |
15,836 |
15,197 |
$629K |
| T4530 |
Ped size brief/diaper lg |
5,975 |
5,693 |
$607K |
| B4088 |
Gastro/jejuno tube, low-pro |
6,039 |
5,647 |
$549K |
| E0424 |
Stationary compressed gas 02 |
2,618 |
2,526 |
$482K |
| B4150 |
Ef complet w/intact nutrient |
2,067 |
1,823 |
$427K |
| T4522 |
Adult size brief/diaper med |
4,000 |
3,796 |
$427K |
| E0618 |
Apnea monitor |
2,565 |
2,404 |
$357K |
| A4927 |
Non-sterile gloves |
19,502 |
18,389 |
$338K |
| B4034 |
Enter feed supkit syr by day |
2,717 |
2,490 |
$327K |
| S5199 |
Personal care item nos each |
1,644 |
1,006 |
$307K |
| E0550 |
Humidif extens supple w ippb |
6,304 |
6,118 |
$291K |
| E0601 |
Cont airway pressure device |
4,104 |
4,014 |
$290K |
| A7003 |
Nebulizer administration set |
24,244 |
10,608 |
$267K |
| A4217 |
Sterile water/saline, 500 ml |
5,522 |
4,153 |
$263K |
| A4629 |
Tracheostomy care kit |
3,312 |
3,072 |
$252K |
| B4152 |
Ef calorie dense>/=1.5kcal |
902 |
843 |
$244K |
| A7508 |
Housing & integrated adhesiv |
3,943 |
3,591 |
$207K |
| T4526 |
Adult size pull-on med |
1,329 |
1,271 |
$199K |
| E0470 |
Rad w/o backup non-inv intfc |
1,184 |
1,153 |
$195K |
| E0570 |
Nebulizer with compression |
1,959 |
1,900 |
$182K |
| E1399 |
Durable medical equipment mi |
968 |
581 |
$180K |
| A6402 |
Sterile gauze <= 16 sq in |
10,699 |
10,152 |
$179K |
| E0565 |
Compressor air power source |
4,223 |
4,088 |
$173K |
| T4523 |
Adult size brief/diaper lg |
1,255 |
1,159 |
$162K |
| A7520 |
Trach/laryn tube non-cuffed |
3,330 |
3,050 |
$143K |
| A4216 |
Sterile water/saline, 10 ml |
3,870 |
3,546 |
$131K |
| E0600 |
Suction pump portab hom modl |
4,005 |
3,873 |
$122K |
| E0471 |
Rad w/backup non inv intrfc |
292 |
279 |
$115K |
| T4521 |
Adult size brief/diaper sm |
1,096 |
1,047 |
$103K |
| A7526 |
Tracheostomy tube collar |
5,353 |
4,946 |
$97K |
| A4244 |
Alcohol or peroxide per pint |
4,236 |
3,948 |
$91K |
| E0466 |
Home vent non-invasive inter |
115 |
112 |
$84K |
| A4245 |
Alcohol wipes per box |
5,376 |
5,079 |
$81K |
| E0562 |
Humidifier heated used w pap |
5,552 |
5,412 |
$67K |
| A7525 |
Tracheostomy mask |
10,626 |
3,509 |
$60K |
| A7002 |
Tubing used w suction pump |
8,934 |
8,352 |
$50K |
| A6216 |
Non-sterile gauze<=16 sq in |
5,858 |
5,543 |
$50K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
617 |
346 |
$49K |
| A7007 |
Lg vol nebulizer disposable |
3,510 |
1,427 |
$42K |
| A7012 |
Nebulizer water collec devic |
2,557 |
2,347 |
$35K |
| E0776 |
Iv pole |
2,261 |
2,202 |
$27K |
| T4527 |
Adult size pull-on lg |
143 |
138 |
$27K |
| A4332 |
Lube sterile packet |
1,898 |
1,753 |
$25K |
| A7015 |
Aerosol mask used w nebulize |
6,353 |
6,034 |
$22K |
| A7010 |
Disposable corrugated tubing |
1,118 |
1,050 |
$22K |
| A4371 |
Skin barrier powder per oz |
2,076 |
1,954 |
$20K |
| B4155 |
Ef incomplete/modular |
551 |
488 |
$18K |
| B4087 |
Gastro/jejuno tube, std |
738 |
359 |
$9K |
| A7000 |
Disposable canister for pump |
1,450 |
1,353 |
$8K |
| A4406 |
Pectin based ostomy paste |
480 |
450 |
$7K |
| A5120 |
Skin barrier, wipe or swab |
855 |
794 |
$6K |
| A4450 |
Non-waterproof tape |
200 |
193 |
$5K |
| A4930 |
Sterile, gloves per pair |
24 |
24 |
$4K |
| A4627 |
Spacer bag/reservoir |
114 |
114 |
$3K |
| A4402 |
Lubricant per ounce |
377 |
350 |
$2K |
| E0480 |
Percussor elect/pneum home m |
25 |
24 |
$907.61 |
| A4456 |
Adhesive remover, wipes |
14 |
13 |
$142.80 |