| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
41,410 |
36,588 |
$9.08M |
| E0465 |
Home vent invasive interface |
10,221 |
8,971 |
$6.83M |
| A4624 |
Tracheal suction tube |
13,998 |
11,445 |
$5.10M |
| B4161 |
Ef ped hydrolyzed/amino acid |
9,836 |
7,922 |
$4.57M |
| S8189 |
Trach supply noc |
38,418 |
14,151 |
$3.11M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
17,527 |
14,825 |
$3.01M |
| T4541 |
Large disposable underpad |
53,934 |
50,452 |
$2.80M |
| B9998 |
Enteral supp not otherwise c |
37,246 |
27,238 |
$2.37M |
| A4606 |
Oxygen probe used w oximeter |
22,394 |
19,062 |
$2.16M |
| E1390 |
Oxygen concentrator |
30,143 |
26,331 |
$2.08M |
| T4523 |
Adult size brief/diaper lg |
13,326 |
12,395 |
$1.94M |
| B4149 |
Ef blenderized foods |
5,788 |
4,780 |
$1.74M |
| T4522 |
Adult size brief/diaper med |
15,244 |
14,382 |
$1.71M |
| A6210 |
Foam drg >16<=48 sq in w/o b |
6,156 |
5,263 |
$1.71M |
| T4535 |
Disposable liner/shield/pad |
24,626 |
23,174 |
$1.54M |
| B4088 |
Gastro/jejuno tube, low-pro |
21,838 |
17,818 |
$1.53M |
| A4353 |
Intermittent urinary cath |
1,772 |
1,591 |
$1.50M |
| A4927 |
Non-sterile gloves |
67,543 |
60,751 |
$1.50M |
| E1399 |
Durable medical equipment mi |
8,384 |
5,506 |
$1.44M |
| B4153 |
Ef hydrolyzed/amino acids |
2,470 |
2,189 |
$1.44M |
| T4530 |
Ped size brief/diaper lg |
11,574 |
10,891 |
$1.34M |
| A7526 |
Tracheostomy tube collar |
15,796 |
13,842 |
$1.28M |
| A4483 |
Moisture exchanger |
11,588 |
8,909 |
$1.28M |
| A7520 |
Trach/laryn tube non-cuffed |
7,993 |
6,575 |
$1.15M |
| T4534 |
Youth size pull-on |
5,945 |
5,616 |
$1.07M |
| A9999 |
Dme supply or accessory, nos |
22,626 |
14,977 |
$991K |
| A4629 |
Tracheostomy care kit |
9,292 |
8,036 |
$955K |
| A4351 |
Straight tip urine catheter |
4,963 |
4,213 |
$928K |
| B9002 |
Enter nutr inf pump any type |
9,379 |
7,412 |
$897K |
| T4527 |
Adult size pull-on lg |
5,846 |
5,420 |
$861K |
| T4526 |
Adult size pull-on med |
6,012 |
5,606 |
$814K |
| T4524 |
Adult size brief/diaper xl |
5,073 |
4,696 |
$809K |
| A4657 |
Syringe w/wo needle |
26,683 |
23,394 |
$802K |
| B4150 |
Ef complet w/intact nutrient |
4,708 |
3,998 |
$734K |
| B4152 |
Ef calorie dense>/=1.5kcal |
3,922 |
3,252 |
$635K |
| T4528 |
Adult size pull-on xl |
3,946 |
3,725 |
$578K |
| E0445 |
Oximeter non-invasive |
5,854 |
4,439 |
$556K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
2,635 |
2,335 |
$542K |
| A4623 |
Tracheostomy inner cannula |
4,183 |
3,529 |
$539K |
| K0738 |
Portable gas oxygen system |
18,223 |
16,048 |
$516K |
| T4521 |
Adult size brief/diaper sm |
4,162 |
3,918 |
$513K |
| A6212 |
Foam drg <=16 sq in w/border |
2,287 |
1,905 |
$493K |
| A4213 |
20+ cc syringe only |
17,657 |
15,524 |
$472K |
| T4525 |
Adult size pull-on sm |
2,774 |
2,617 |
$461K |
| E0466 |
Home vent non-invasive inter |
696 |
611 |
$442K |
| A4628 |
Oropharyngeal suction cath |
23,126 |
20,345 |
$440K |
| A7000 |
Disposable canister for pump |
25,226 |
21,905 |
$412K |
| A4217 |
Sterile water/saline, 500 ml |
10,987 |
9,345 |
$370K |
| A6402 |
Sterile gauze <= 16 sq in |
24,621 |
21,207 |
$365K |
| B4154 |
Ef spec metabolic noninherit |
1,098 |
944 |
$279K |
| E0482 |
Cough stimulating device |
737 |
656 |
$267K |
| A4554 |
Disposable underpads |
5,502 |
5,045 |
$260K |
| E0600 |
Suction pump portab hom modl |
3,389 |
2,863 |
$257K |
| A7507 |
Integrated filter & holder |
3,786 |
3,069 |
$231K |
| A7002 |
Tubing used w suction pump |
24,622 |
21,878 |
$228K |
| A5200 |
Percutaneous catheter anchor |
5,777 |
4,881 |
$223K |
| T4532 |
Ped size pull-on lg |
1,421 |
1,301 |
$222K |
| A6403 |
Sterile gauze>16 <= 48 sq in |
3,762 |
3,286 |
$207K |
| B4158 |
Ef ped complete intact nut |
1,502 |
1,276 |
$205K |
| A9900 |
Supply/accessory/service |
3,414 |
2,740 |
$198K |
| B4034 |
Enter feed supkit syr by day |
2,324 |
1,973 |
$198K |
| E0431 |
Portable gaseous 02 |
11,095 |
10,148 |
$189K |
| A4245 |
Alcohol wipes per box |
12,904 |
11,299 |
$187K |
| L8501 |
Tracheostomy speaking valve |
2,094 |
1,848 |
$176K |
| T4543 |
Adult disp brief/diap abv xl |
740 |
671 |
$172K |
| A6250 |
Skin seal protect moisturizr |
3,776 |
3,157 |
$171K |
| A4357 |
Bedside drainage bag |
3,586 |
2,770 |
$171K |
| B4155 |
Ef incomplete/modular |
5,478 |
4,847 |
$171K |
| B4103 |
Ef ped fluid and electrolyte |
1,498 |
1,287 |
$169K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,323 |
1,143 |
$158K |
| B4036 |
Enteral feed sup kit grav by |
1,832 |
1,668 |
$154K |
| A4605 |
Trach suction cath close sys |
714 |
619 |
$153K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
1,337 |
1,169 |
$133K |
| A7003 |
Nebulizer administration set |
25,048 |
22,060 |
$108K |
| T4533 |
Youth size brief/diaper |
875 |
822 |
$107K |
| A6196 |
Alginate dressing <=16 sq in |
591 |
517 |
$106K |
| K0739 |
Repair/svc dme non-oxygen eq |
2,075 |
1,875 |
$91K |
| E0570 |
Nebulizer with compression |
2,262 |
1,974 |
$90K |
| A4210 |
Nonneedle injection device |
9,364 |
6,812 |
$89K |
| E0776 |
Iv pole |
1,904 |
1,492 |
$86K |
| B4102 |
Ef adult fluids and electro |
441 |
380 |
$74K |
| A6197 |
Alginate drsg >16 <=48 sq in |
310 |
252 |
$71K |
| A7007 |
Lg vol nebulizer disposable |
8,097 |
6,945 |
$65K |
| A4310 |
Insert tray w/o bag/cath |
776 |
638 |
$65K |
| A4553 |
Nondisp underpads, all sizes |
4,237 |
3,960 |
$62K |
| A4452 |
Waterproof tape |
3,033 |
2,729 |
$59K |
| A4352 |
Coude tip urinary catheter |
83 |
74 |
$56K |
| E0565 |
Compressor air power source |
581 |
480 |
$56K |
| A5120 |
Skin barrier, wipe or swab |
4,664 |
3,817 |
$55K |
| A7525 |
Tracheostomy mask |
7,971 |
6,867 |
$52K |
| T5999 |
Supply, nos |
1,459 |
985 |
$50K |
| A4402 |
Lubricant per ounce |
9,029 |
8,114 |
$50K |
| A4456 |
Adhesive remover, wipes |
4,086 |
3,511 |
$49K |
| A4450 |
Non-waterproof tape |
13,340 |
11,892 |
$48K |
| A4385 |
Ost skn barrier sld ext wear |
558 |
478 |
$47K |
| A6260 |
Wound cleanser any type/size |
2,798 |
2,405 |
$46K |
| B4087 |
Gastro/jejuno tube, std |
1,743 |
1,572 |
$44K |
| E0630 |
Patient lift hydraulic |
450 |
386 |
$42K |
| A7012 |
Nebulizer water collec devic |
5,370 |
4,685 |
$41K |
| A4332 |
Lube sterile packet |
3,307 |
2,957 |
$40K |
| A4216 |
Sterile water/saline, 10 ml |
2,261 |
1,989 |
$39K |
| A7010 |
Disposable corrugated tubing |
2,913 |
2,581 |
$39K |
| A4358 |
Urinary leg or abdomen bag |
1,729 |
1,333 |
$38K |
| A4349 |
Disposable male external cat |
1,135 |
874 |
$38K |
| A4344 |
Cath indw foley 2 way silicn |
344 |
271 |
$35K |
| E0562 |
Humidifier heated used w pap |
2,155 |
1,937 |
$35K |
| A4930 |
Sterile, gloves per pair |
506 |
448 |
$34K |
| A7018 |
Water distilled w/nebulizer |
11,970 |
10,536 |
$33K |
| A7521 |
Trach/laryn tube cuffed |
472 |
340 |
$32K |
| K0001 |
Standard wheelchair |
1,826 |
1,490 |
$32K |
| A7013 |
Disposable compressor filter |
23,686 |
19,146 |
$21K |
| A7037 |
Pos airway pressure tubing |
1,673 |
1,477 |
$21K |
| E0619 |
Apnea monitor w recorder |
111 |
89 |
$20K |
| S8186 |
Swivel adaptor |
2,647 |
2,398 |
$20K |
| E0601 |
Cont airway pressure device |
441 |
398 |
$20K |
| A7031 |
Replacement facemask interfa |
604 |
541 |
$18K |
| E0261 |
Hosp bed semi-electr w/o mat |
379 |
330 |
$17K |
| A4627 |
Spacer bag/reservoir |
579 |
518 |
$17K |
| A4425 |
Ost pch drain for barrier fl |
175 |
145 |
$17K |
| B4100 |
Food thickener oral |
88 |
80 |
$16K |
| E0439 |
Stationary liquid 02 |
110 |
107 |
$15K |
| K0195 |
Elevating whlchair leg rests |
1,930 |
1,574 |
$15K |
| T4529 |
Ped size brief/diaper sm/med |
153 |
139 |
$14K |
| A4335 |
Incontinence supply |
5,442 |
5,333 |
$14K |
| A4520 |
Incontinence garment anytype |
210 |
188 |
$13K |
| A7034 |
Nasal application device |
236 |
212 |
$12K |
| A7032 |
Replacement nasal cushion |
324 |
288 |
$11K |
| A4409 |
Ost skn barr convex <=4 sq i |
68 |
62 |
$11K |
| A6453 |
Self-adher band w <3"/yd |
4,912 |
4,361 |
$10K |
| A7038 |
Pos airway pressure filter |
2,968 |
2,568 |
$10K |
| T4537 |
Reusable underpad bed size |
1,040 |
975 |
$10K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
106 |
92 |
$9K |
| A7030 |
Cpap full face mask |
109 |
99 |
$8K |
| A6258 |
Transparent film >16<=48 in |
57 |
51 |
$8K |
| B9999 |
Parenteral supp not othrws c |
88 |
66 |
$8K |
| A7014 |
Compressor nondispos filter |
2,441 |
2,265 |
$7K |
| T4540 |
Reusable underpad chair size |
434 |
413 |
$7K |
| S8121 |
O2 contents liquid lb |
121 |
69 |
$7K |
| A4616 |
Tubing (oxygen) per foot |
4,249 |
3,664 |
$7K |
| E0434 |
Portable liquid 02 |
261 |
253 |
$6K |
| B4082 |
Enteral ng tubing w/o stylet |
202 |
153 |
$6K |
| A4615 |
Cannula nasal |
2,426 |
2,197 |
$6K |
| A4371 |
Skin barrier powder per oz |
1,310 |
1,199 |
$6K |
| A7035 |
Pos airway press headgear |
355 |
301 |
$5K |
| E0603 |
Electric breast pump |
522 |
522 |
$5K |
| A7046 |
Repl water chamber, pap dev |
510 |
418 |
$5K |
| A4618 |
Breathing circuits |
221 |
193 |
$5K |
| A7033 |
Replacement nasal pillows |
174 |
159 |
$4K |
| E0971 |
Wheelchair anti-tipping devi |
338 |
264 |
$4K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
13 |
12 |
$3K |
| A4322 |
Irrigation syringe |
89 |
79 |
$3K |
| L7367 |
Replacemnt lithium ionbatter |
29 |
25 |
$3K |
| T4544 |
Adlt disp und/pull on abv xl |
16 |
16 |
$3K |
| A4247 |
Betadine/iodine swabs/wipes |
91 |
83 |
$3K |
| E0471 |
Rad w/backup non inv intrfc |
15 |
12 |
$2K |
| T4531 |
Ped size pull-on sm/med |
12 |
12 |
$2K |
| A7039 |
Filter, non disposable w pap |
373 |
322 |
$2K |
| A4649 |
Surgical supplies |
13 |
13 |
$2K |
| A4253 |
Blood glucose/reagent strips |
41 |
37 |
$1K |
| A4406 |
Pectin based ostomy paste |
86 |
76 |
$1K |
| S8999 |
Resuscitation bag |
44 |
38 |
$918.79 |
| S8120 |
O2 contents gas cubic ft |
30 |
25 |
$628.44 |
| A7527 |
Trach/laryn tube plug/stop |
62 |
49 |
$603.59 |
| A7020 |
Interface, cough stim device |
48 |
38 |
$419.21 |
| A9270 |
Non-covered item or service |
424 |
360 |
$132.42 |
| A6216 |
Non-sterile gauze<=16 sq in |
16 |
12 |
$89.80 |
| A4244 |
Alcohol or peroxide per pint |
12 |
12 |
$14.83 |