| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1019 |
Personal care ser per 15 min |
1,162,388 |
61,490 |
$69.52M |
| T1021 |
Hh aide or cn aide per visit |
2,212,926 |
52,254 |
$39.54M |
| S5130 |
Homaker service nos per 15m |
781,704 |
59,267 |
$27.83M |
| S5150 |
Unskilled respite care /15m |
196,046 |
10,336 |
$12.72M |
| S5135 |
Adult companioncare per 15m |
196,936 |
10,617 |
$7.11M |
| B4161 |
Ef ped hydrolyzed/amino acid |
6,354 |
4,298 |
$2.53M |
| E1399 |
Durable medical equipment mi |
4,234 |
2,565 |
$2.13M |
| E0466 |
Home vent non-invasive inter |
3,576 |
3,365 |
$1.99M |
| E1392 |
Portable oxygen concentrator |
8,830 |
8,061 |
$1.92M |
| E0465 |
Home vent invasive interface |
2,200 |
2,113 |
$1.40M |
| K0739 |
Repair/svc dme non-oxygen eq |
1,353 |
937 |
$840K |
| B9998 |
Enteral supp not otherwise c |
16,409 |
11,231 |
$785K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
6,707 |
4,253 |
$773K |
| 97110 |
|
18,906 |
1,285 |
$749K |
| 97530 |
|
17,034 |
1,212 |
$694K |
| 92507 |
|
18,357 |
1,113 |
$666K |
| E0603 |
Electric breast pump |
6,206 |
5,274 |
$539K |
| B4088 |
Gastro/jejuno tube, low-pro |
6,382 |
5,380 |
$467K |
| S9131 |
Pt in the home per diem |
5,130 |
1,146 |
$448K |
| B4153 |
Ef hydrolyzed/amino acids |
833 |
660 |
$409K |
| E1390 |
Oxygen concentrator |
4,571 |
4,143 |
$404K |
| B4154 |
Ef spec metabolic noninherit |
938 |
654 |
$255K |
| B4150 |
Ef complet w/intact nutrient |
2,212 |
1,524 |
$233K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,069 |
1,826 |
$232K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,181 |
985 |
$198K |
| S9128 |
Speech therapy, in the home, |
1,670 |
226 |
$124K |
| S9129 |
Occupational therapy, in the |
1,652 |
354 |
$110K |
| 97163 |
|
548 |
423 |
$104K |
| E0570 |
Nebulizer with compression |
3,007 |
2,771 |
$103K |
| B4149 |
Ef blenderized foods |
481 |
243 |
$84K |
| B4155 |
Ef incomplete/modular |
1,407 |
1,027 |
$83K |
| K0001 |
Standard wheelchair |
5,036 |
4,581 |
$81K |
| K0008 |
Cstm manual wheelchair/base |
17 |
12 |
$73K |
| E0601 |
Cont airway pressure device |
4,094 |
3,276 |
$54K |
| E0277 |
Powered pres-redu air mattrs |
653 |
556 |
$49K |
| B4035 |
Enteral feed supp pump per d |
349 |
330 |
$48K |
| T1001 |
Nursing assessment/evaluatn |
480 |
449 |
$44K |
| A4554 |
Disposable underpads |
680 |
465 |
$44K |
| E0431 |
Portable gaseous 02 |
3,340 |
3,045 |
$37K |
| T1002 |
Rn services up to 15 minutes |
369 |
25 |
$33K |
| T4534 |
Youth size pull-on |
224 |
169 |
$31K |
| T1030 |
Rn home care per diem |
387 |
290 |
$31K |
| T4530 |
Ped size brief/diaper lg |
315 |
241 |
$27K |
| E0630 |
Patient lift hydraulic |
538 |
526 |
$25K |
| B9002 |
Enter nutr inf pump any type |
747 |
652 |
$22K |
| E0143 |
Walker folding wheeled w/o s |
489 |
431 |
$19K |
| E0445 |
Oximeter non-invasive |
431 |
358 |
$11K |
| A4623 |
Tracheostomy inner cannula |
187 |
166 |
$8K |
| E0562 |
Humidifier heated used w pap |
5,409 |
4,572 |
$7K |
| K0800 |
Pov group 1 std up to 300lbs |
559 |
482 |
$7K |
| K0003 |
Lightweight wheelchair |
156 |
150 |
$6K |
| A7526 |
Tracheostomy tube collar |
1,578 |
1,134 |
$6K |
| 97161 |
|
30 |
25 |
$6K |
| 97166 |
|
110 |
85 |
$6K |
| A4213 |
20+ cc syringe only |
564 |
467 |
$5K |
| A6402 |
Sterile gauze <= 16 sq in |
981 |
792 |
$5K |
| 97162 |
|
15 |
14 |
$4K |
| A4927 |
Non-sterile gloves |
206 |
145 |
$4K |
| E2365 |
U1 sealed leadacid battery |
680 |
572 |
$4K |
| A4217 |
Sterile water/saline, 500 ml |
320 |
264 |
$4K |
| A5120 |
Skin barrier, wipe or swab |
910 |
763 |
$3K |
| K0108 |
W/c component-accessory nos |
14 |
12 |
$3K |
| K0007 |
Extra heavy duty wheelchair |
58 |
50 |
$3K |
| E0149 |
Heavy duty wheeled walker |
31 |
30 |
$3K |
| A4216 |
Sterile water/saline, 10 ml |
228 |
206 |
$3K |
| E0470 |
Rad w/o backup non-inv intfc |
162 |
142 |
$2K |
| B4034 |
Enter feed supkit syr by day |
30 |
29 |
$2K |
| A4628 |
Oropharyngeal suction cath |
180 |
150 |
$2K |
| E0250 |
Hosp bed fixed ht w/ mattres |
50 |
48 |
$2K |
| K0813 |
Pwc gp 1 std port seat/back |
32 |
24 |
$2K |
| A4357 |
Bedside drainage bag |
109 |
101 |
$2K |
| E2601 |
Gen w/c cushion wdth < 22 in |
112 |
106 |
$1K |
| A7003 |
Nebulizer administration set |
104 |
100 |
$1K |
| A7037 |
Pos airway pressure tubing |
31 |
30 |
$855.92 |
| K0821 |
Pwc gp 2 std port cap chair |
28 |
26 |
$759.00 |
| A7038 |
Pos airway pressure filter |
207 |
189 |
$743.09 |
| A7002 |
Tubing used w suction pump |
75 |
53 |
$647.26 |
| A4604 |
Tubing with heating element |
476 |
447 |
$468.49 |
| A4450 |
Non-waterproof tape |
159 |
142 |
$441.99 |
| K0195 |
Elevating whlchair leg rests |
351 |
327 |
$408.03 |
| E1038 |
Transport chair pt wt<=300lb |
175 |
141 |
$396.89 |
| E0181 |
Press pad alternating w/ pum |
65 |
65 |
$268.68 |
| E0565 |
Compressor air power source |
38 |
36 |
$256.46 |
| E0156 |
Walker seat attachment |
284 |
236 |
$254.67 |
| A7046 |
Repl water chamber, pap dev |
41 |
39 |
$155.71 |
| A7034 |
Nasal application device |
13 |
12 |
$155.29 |
| A7035 |
Pos airway press headgear |
26 |
25 |
$152.84 |
| A7000 |
Disposable canister for pump |
35 |
30 |
$116.29 |
| E0971 |
Wheelchair anti-tipping devi |
76 |
38 |
$47.08 |
| A4310 |
Insert tray w/o bag/cath |
30 |
27 |
$29.00 |
| E0776 |
Iv pole |
14 |
12 |
$7.95 |
| A6446 |
Conform band s w>=3" <5"/yd |
12 |
12 |
$5.76 |
| A7015 |
Aerosol mask used w nebulize |
83 |
81 |
$2.58 |
| A4358 |
Urinary leg or abdomen bag |
56 |
51 |
$0.00 |
| A6447 |
Conform band s w >=5"/yd |
42 |
33 |
$0.00 |
| A4618 |
Breathing circuits |
49 |
47 |
$0.00 |
| 99601 |
|
31 |
12 |
$0.00 |
| A4338 |
Indwelling catheter latex |
29 |
25 |
$0.00 |
| G0156 |
Hhcp-svs of aide,ea 15 min |
2,348 |
96 |
$0.00 |
| Q5002 |
Hospice/home hlth in asst lv |
116 |
62 |
$0.00 |
| G0300 |
Hhs/hospice of lpn ea 15 min |
3,122 |
149 |
$0.00 |
| G0299 |
Hhs/hospice of rn ea 15 min |
456 |
167 |
$0.00 |
| Q5001 |
Hospice or home hlth in home |
760 |
242 |
$0.00 |
| 84160 |
|
28 |
28 |
$0.00 |
| G0152 |
Hhcp-serv of ot,ea 15 min |
48 |
21 |
$0.00 |
| G0151 |
Hhcp-serv of pt,ea 15 min |
338 |
111 |
$0.00 |