| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
4,919 |
4,680 |
$1.86M |
| B9998 |
Enteral supp not otherwise c |
9,954 |
5,071 |
$1.27M |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,398 |
1,274 |
$1.18M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,505 |
2,055 |
$696K |
| T4541 |
Large disposable underpad |
8,372 |
8,068 |
$479K |
| T4522 |
Adult size brief/diaper med |
1,903 |
1,832 |
$395K |
| T4530 |
Ped size brief/diaper lg |
2,074 |
1,986 |
$393K |
| A4927 |
Non-sterile gloves |
11,847 |
11,079 |
$370K |
| A4320 |
Irrigation tray |
2,070 |
1,995 |
$341K |
| B4150 |
Ef complet w/intact nutrient |
1,148 |
865 |
$340K |
| T4534 |
Youth size pull-on |
1,884 |
1,771 |
$275K |
| A4312 |
Cath w/o bag 2-way silicone |
1,088 |
1,038 |
$257K |
| T4524 |
Adult size brief/diaper xl |
768 |
734 |
$209K |
| A4606 |
Oxygen probe used w oximeter |
1,618 |
1,405 |
$200K |
| T4523 |
Adult size brief/diaper lg |
657 |
632 |
$170K |
| T4526 |
Adult size pull-on med |
1,235 |
1,121 |
$157K |
| B4088 |
Gastro/jejuno tube, low-pro |
1,069 |
938 |
$156K |
| T4521 |
Adult size brief/diaper sm |
731 |
703 |
$129K |
| T2029 |
Special med equip, noswaiver |
4,348 |
2,847 |
$86K |
| A4628 |
Oropharyngeal suction cath |
1,695 |
1,560 |
$82K |
| T4527 |
Adult size pull-on lg |
564 |
543 |
$79K |
| B4149 |
Ef blenderized foods |
87 |
64 |
$78K |
| T4528 |
Adult size pull-on xl |
313 |
303 |
$58K |
| A4333 |
Urinary cath anchor device |
1,107 |
1,011 |
$57K |
| A7001 |
Nondisposable pump canister |
1,453 |
1,381 |
$57K |
| A6402 |
Sterile gauze <= 16 sq in |
3,852 |
3,665 |
$52K |
| T4525 |
Adult size pull-on sm |
240 |
218 |
$37K |
| A7002 |
Tubing used w suction pump |
1,556 |
1,476 |
$27K |
| A7005 |
Nondisposable nebulizer set |
1,034 |
901 |
$26K |
| B9002 |
Enter nutr inf pump any type |
18 |
18 |
$25K |
| A4322 |
Irrigation syringe |
113 |
111 |
$11K |
| A4657 |
Syringe w/wo needle |
2,780 |
2,482 |
$10K |
| A6260 |
Wound cleanser any type/size |
1,068 |
1,027 |
$10K |
| A4649 |
Surgical supplies |
1,476 |
1,232 |
$8K |
| A7000 |
Disposable canister for pump |
64 |
57 |
$1K |
| B4036 |
Enteral feed sup kit grav by |
84 |
80 |
$1K |
| A9999 |
Dme supply or accessory, nos |
63 |
62 |
$491.84 |
| A4554 |
Disposable underpads |
42 |
42 |
$118.40 |
| S8189 |
Trach supply noc |
17 |
13 |
$92.08 |