| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
250,086 |
13,814 |
$2.37M |
| B9998 |
Enteral supp not otherwise c |
29,307 |
13,352 |
$1.42M |
| E1390 |
Oxygen concentrator |
17,130 |
13,615 |
$1.17M |
| E0465 |
Home vent invasive interface |
2,079 |
1,579 |
$1.01M |
| E0466 |
Home vent non-invasive inter |
1,861 |
1,392 |
$872K |
| A4624 |
Tracheal suction tube |
6,862 |
4,184 |
$834K |
| A4606 |
Oxygen probe used w oximeter |
21,095 |
6,086 |
$618K |
| B4088 |
Gastro/jejuno tube, low-pro |
8,347 |
4,885 |
$569K |
| A4628 |
Oropharyngeal suction cath |
8,084 |
6,441 |
$556K |
| A9999 |
Dme supply or accessory, nos |
41,709 |
7,190 |
$420K |
| T4530 |
Ped size brief/diaper lg |
56,372 |
4,429 |
$399K |
| A7520 |
Trach/laryn tube non-cuffed |
3,815 |
2,010 |
$355K |
| E2402 |
Neg press wound therapy pump |
978 |
677 |
$327K |
| A7521 |
Trach/laryn tube cuffed |
898 |
426 |
$326K |
| B9002 |
Enter nutr inf pump any type |
588 |
465 |
$284K |
| A7526 |
Tracheostomy tube collar |
3,622 |
2,832 |
$274K |
| T4522 |
Adult size brief/diaper med |
32,735 |
2,811 |
$262K |
| B4034 |
Enter feed supkit syr by day |
45,807 |
3,577 |
$255K |
| E1150 |
Wheelchair standard w/ leg r |
6,142 |
3,819 |
$245K |
| T4534 |
Youth size pull-on |
33,525 |
2,106 |
$208K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
1,413 |
1,098 |
$204K |
| A4629 |
Tracheostomy care kit |
2,694 |
2,053 |
$201K |
| A4217 |
Sterile water/saline, 500 ml |
2,630 |
2,191 |
$145K |
| E0431 |
Portable gaseous 02 |
11,809 |
9,172 |
$144K |
| T4523 |
Adult size brief/diaper lg |
13,224 |
1,156 |
$139K |
| A4483 |
Moisture exchanger |
5,637 |
1,518 |
$137K |
| A4353 |
Intermittent urinary cath |
211 |
162 |
$133K |
| T4531 |
Ped size pull-on sm/med |
21,576 |
1,343 |
$124K |
| A4216 |
Sterile water/saline, 10 ml |
7,561 |
3,908 |
$114K |
| T4521 |
Adult size brief/diaper sm |
13,251 |
1,261 |
$112K |
| E0443 |
Portable 02 contents, gas |
2,114 |
1,279 |
$103K |
| E0600 |
Suction pump portab hom modl |
1,038 |
662 |
$100K |
| A7000 |
Disposable canister for pump |
10,751 |
7,996 |
$100K |
| E0570 |
Nebulizer with compression |
1,933 |
1,597 |
$98K |
| A7507 |
Integrated filter & holder |
4,639 |
1,214 |
$97K |
| E0261 |
Hosp bed semi-electr w/o mat |
3,300 |
1,845 |
$92K |
| E1060 |
Wheelchair detachable arms |
1,119 |
942 |
$89K |
| T4532 |
Ped size pull-on lg |
13,212 |
740 |
$82K |
| A4222 |
Infusion supplies with pump |
2,011 |
1,029 |
$80K |
| E0630 |
Patient lift hydraulic |
2,503 |
1,671 |
$76K |
| T4533 |
Youth size brief/diaper |
1,256 |
604 |
$62K |
| E0143 |
Walker folding wheeled w/o s |
2,614 |
1,828 |
$61K |
| A6550 |
Neg pres wound ther drsg set |
1,101 |
457 |
$59K |
| E1140 |
Wheelchair standard detach a |
548 |
485 |
$59K |
| T4529 |
Ped size brief/diaper sm/med |
6,218 |
640 |
$58K |
| A7005 |
Nondisposable nebulizer set |
3,878 |
3,136 |
$52K |
| E0445 |
Oximeter non-invasive |
72 |
29 |
$50K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,188 |
999 |
$47K |
| A4221 |
Supp non-insulin inf cath/wk |
2,696 |
1,068 |
$39K |
| E0165 |
Commode chair with detacharm |
2,056 |
1,219 |
$35K |
| K0001 |
Standard wheelchair |
4,269 |
3,392 |
$33K |
| E0163 |
Commode chair with fixed arm |
1,677 |
1,174 |
$33K |
| A7002 |
Tubing used w suction pump |
9,875 |
7,568 |
$32K |
| A4554 |
Disposable underpads |
11,657 |
1,237 |
$31K |
| E0776 |
Iv pole |
447 |
337 |
$30K |
| A4351 |
Straight tip urine catheter |
188 |
163 |
$25K |
| T4525 |
Adult size pull-on sm |
3,940 |
233 |
$22K |
| A7525 |
Tracheostomy mask |
2,965 |
2,137 |
$18K |
| A6402 |
Sterile gauze <= 16 sq in |
2,360 |
1,885 |
$18K |
| A4402 |
Lubricant per ounce |
3,254 |
2,656 |
$15K |
| A4322 |
Irrigation syringe |
1,193 |
518 |
$15K |
| A7010 |
Disposable corrugated tubing |
1,299 |
1,048 |
$14K |
| A4209 |
5+ cc sterile syringe&needle |
1,993 |
1,527 |
$10K |
| A4305 |
Drug delivery system >=50 ml |
154 |
27 |
$9K |
| A4627 |
Spacer bag/reservoir |
400 |
347 |
$9K |
| A4623 |
Tracheostomy inner cannula |
477 |
294 |
$9K |
| K0195 |
Elevating whlchair leg rests |
3,628 |
2,387 |
$7K |
| A4927 |
Non-sterile gloves |
1,543 |
1,059 |
$7K |
| A7003 |
Nebulizer administration set |
3,327 |
2,935 |
$6K |
| A7015 |
Aerosol mask used w nebulize |
5,366 |
4,514 |
$6K |
| A7007 |
Lg vol nebulizer disposable |
2,166 |
1,699 |
$5K |
| A6212 |
Foam drg <=16 sq in w/border |
45 |
27 |
$4K |
| A4605 |
Trach suction cath close sys |
20 |
12 |
$4K |
| A7012 |
Nebulizer water collec devic |
1,981 |
1,511 |
$4K |
| E0184 |
Dry pressure mattress |
67 |
52 |
$4K |
| B4152 |
Ef calorie dense>/=1.5kcal |
150 |
107 |
$3K |
| E0149 |
Heavy duty wheeled walker |
324 |
148 |
$3K |
| E1092 |
Wheelchair wide w/ leg rests |
15 |
13 |
$3K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
429 |
396 |
$2K |
| B4154 |
Ef spec metabolic noninherit |
50 |
39 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
2,180 |
939 |
$2K |
| A4244 |
Alcohol or peroxide per pint |
666 |
587 |
$2K |
| K0003 |
Lightweight wheelchair |
315 |
212 |
$2K |
| K0006 |
Heavy duty wheelchair |
200 |
164 |
$2K |
| T4526 |
Adult size pull-on med |
282 |
12 |
$1K |
| E0978 |
W/c acc,saf belt pelv strap |
898 |
713 |
$1K |
| E0601 |
Cont airway pressure device |
37 |
24 |
$972.76 |
| A6250 |
Skin seal protect moisturizr |
106 |
86 |
$787.19 |
| E0562 |
Humidifier heated used w pap |
59 |
50 |
$529.64 |
| B4161 |
Ef ped hydrolyzed/amino acid |
83 |
72 |
$508.95 |
| E2601 |
Gen w/c cushion wdth < 22 in |
96 |
53 |
$474.01 |
| B4150 |
Ef complet w/intact nutrient |
18 |
12 |
$365.23 |
| A4450 |
Non-waterproof tape |
216 |
153 |
$342.73 |
| E0951 |
Loop heel |
721 |
336 |
$208.43 |
| B4149 |
Ef blenderized foods |
28 |
24 |
$0.00 |