| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Straight tip urine catheter |
11,955 |
11,321 |
$3.70M |
| B4035 |
Enteral feed supp pump per d |
14,616 |
14,201 |
$2.01M |
| T4541 |
Large disposable underpad |
31,210 |
30,578 |
$1.54M |
| B9998 |
Enteral supp not otherwise c |
23,166 |
19,628 |
$1.54M |
| A4322 |
Irrigation syringe |
18,477 |
18,197 |
$1.53M |
| T4523 |
Adult size brief/diaper lg |
10,743 |
10,667 |
$1.12M |
| T4522 |
Adult size brief/diaper med |
12,680 |
12,533 |
$1.08M |
| B4088 |
Gastro/jejuno tube, low-pro |
7,117 |
6,970 |
$909K |
| A4344 |
Cath indw foley 2 way silicn |
1,320 |
1,314 |
$543K |
| T4524 |
Adult size brief/diaper xl |
5,182 |
5,135 |
$465K |
| A7520 |
Trach/laryn tube non-cuffed |
1,987 |
1,958 |
$348K |
| T4535 |
Disposable liner/shield/pad |
5,886 |
5,767 |
$335K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,836 |
1,412 |
$326K |
| A6402 |
Sterile gauze <= 16 sq in |
18,890 |
17,456 |
$312K |
| A6211 |
Foam drg > 48 sq in w/o brdr |
170 |
142 |
$290K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
379 |
329 |
$285K |
| T4521 |
Adult size brief/diaper sm |
3,017 |
2,938 |
$223K |
| A4927 |
Non-sterile gloves |
11,042 |
10,914 |
$218K |
| A7526 |
Tracheostomy tube collar |
1,724 |
1,720 |
$202K |
| T4526 |
Adult size pull-on med |
3,471 |
3,389 |
$194K |
| A6250 |
Skin seal protect moisturizr |
13,415 |
13,094 |
$170K |
| T4530 |
Ped size brief/diaper lg |
1,761 |
1,716 |
$154K |
| A4657 |
Syringe w/wo needle |
17,701 |
11,680 |
$145K |
| A4628 |
Oropharyngeal suction cath |
6,405 |
6,269 |
$133K |
| S9435 |
Medical foods for inborn err |
136 |
136 |
$130K |
| T4525 |
Adult size pull-on sm |
2,382 |
2,368 |
$123K |
| A4624 |
Tracheal suction tube |
1,502 |
1,451 |
$117K |
| Z5999 |
|
370 |
331 |
$107K |
| A7002 |
Tubing used w suction pump |
6,733 |
6,659 |
$105K |
| A7000 |
Disposable canister for pump |
6,081 |
5,907 |
$97K |
| A4409 |
Ost skn barr convex <=4 sq i |
658 |
658 |
$95K |
| A4335 |
Incontinence supply |
13,545 |
13,191 |
$82K |
| B4150 |
Ef complet w/intact nutrient |
529 |
419 |
$73K |
| A4352 |
Coude tip urinary catheter |
167 |
165 |
$72K |
| T4534 |
Youth size pull-on |
587 |
584 |
$68K |
| T4527 |
Adult size pull-on lg |
943 |
939 |
$68K |
| A4357 |
Bedside drainage bag |
1,411 |
1,405 |
$62K |
| A5061 |
Pouch drainable w barrier at |
701 |
698 |
$62K |
| A4310 |
Insert tray w/o bag/cath |
329 |
329 |
$61K |
| T5999 |
Supply, nos |
593 |
560 |
$54K |
| T4542 |
Small disposable underpad |
1,354 |
1,348 |
$49K |
| K0001 |
Standard wheelchair |
932 |
725 |
$49K |
| A6457 |
Tubular dressing |
1,121 |
731 |
$45K |
| A6446 |
Conform band s w>=3" <5"/yd |
483 |
436 |
$43K |
| T4528 |
Adult size pull-on xl |
602 |
598 |
$41K |
| B9002 |
Enter nutr inf pump any type |
54 |
52 |
$35K |
| A5063 |
Drain ostomy pouch w/flange |
564 |
564 |
$32K |
| T4537 |
Reusable underpad bed size |
980 |
935 |
$26K |
| E0144 |
Enclosed walker w rear seat |
73 |
72 |
$17K |
| B4036 |
Enteral feed sup kit grav by |
475 |
475 |
$16K |
| A4456 |
Adhesive remover, wipes |
1,111 |
1,089 |
$14K |
| A4483 |
Moisture exchanger |
165 |
165 |
$13K |
| A4402 |
Lubricant per ounce |
2,693 |
2,691 |
$13K |
| A5120 |
Skin barrier, wipe or swab |
871 |
855 |
$11K |
| A7003 |
Nebulizer administration set |
2,530 |
2,504 |
$9K |
| A4406 |
Pectin based ostomy paste |
803 |
789 |
$9K |
| A4332 |
Lube sterile packet |
1,294 |
1,290 |
$8K |
| E0143 |
Walker folding wheeled w/o s |
129 |
128 |
$7K |
| E0978 |
W/c acc,saf belt pelv strap |
1,061 |
826 |
$7K |
| A4385 |
Ost skn barrier sld ext wear |
38 |
36 |
$6K |
| A7525 |
Tracheostomy mask |
670 |
668 |
$6K |
| B4087 |
Gastro/jejuno tube, std |
88 |
88 |
$5K |
| E0600 |
Suction pump portab hom modl |
17 |
13 |
$5K |
| E0570 |
Nebulizer with compression |
70 |
70 |
$4K |
| J7131 |
Hypertonic saline sol |
88 |
87 |
$4K |
| A6216 |
Non-sterile gauze<=16 sq in |
453 |
446 |
$4K |
| B4161 |
Ef ped hydrolyzed/amino acid |
16 |
12 |
$4K |
| E0990 |
Wheelchair elevating leg res |
107 |
57 |
$2K |
| T4533 |
Youth size brief/diaper |
24 |
24 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
102 |
52 |
$2K |
| A4371 |
Skin barrier powder per oz |
150 |
150 |
$1K |
| E0156 |
Walker seat attachment |
84 |
83 |
$1K |
| A4425 |
Ost pch drain for barrier fl |
12 |
12 |
$595.05 |
| A7015 |
Aerosol mask used w nebulize |
240 |
238 |
$419.55 |
| E1226 |
Manual fully reclining back |
12 |
12 |
$417.06 |
| A4215 |
Sterile needle |
28 |
27 |
$339.67 |
| A4670 |
Automatic bp monitor, dial |
12 |
12 |
$162.83 |