| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
22,161 |
18,345 |
$15.04M |
| B4035 |
Enteral feed supp pump per d |
41,115 |
38,288 |
$10.71M |
| B4161 |
Ef ped hydrolyzed/amino acid |
11,269 |
10,451 |
$7.04M |
| A4624 |
Tracheal suction tube |
16,699 |
16,028 |
$5.86M |
| A4605 |
Trach suction cath close sys |
12,583 |
12,221 |
$5.06M |
| B4149 |
Ef blenderized foods |
12,264 |
11,376 |
$4.41M |
| E1390 |
Oxygen concentrator |
42,629 |
24,415 |
$3.84M |
| A7507 |
Integrated filter & holder |
22,038 |
20,729 |
$3.65M |
| E0466 |
Home vent non-invasive inter |
4,791 |
4,309 |
$3.51M |
| A9900 |
Supply/accessory/service |
8,829 |
8,696 |
$3.46M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
11,204 |
10,504 |
$2.87M |
| A7526 |
Tracheostomy tube collar |
27,571 |
26,537 |
$1.73M |
| B4088 |
Gastro/jejuno tube, low-pro |
11,598 |
10,877 |
$1.33M |
| A7521 |
Trach/laryn tube cuffed |
14,355 |
13,737 |
$1.31M |
| A4629 |
Tracheostomy care kit |
12,696 |
12,159 |
$1.30M |
| A7520 |
Trach/laryn tube non-cuffed |
14,058 |
13,463 |
$1.28M |
| E0431 |
Portable gaseous 02 |
59,591 |
39,201 |
$1.14M |
| A6210 |
Foam drg >16<=48 sq in w/o b |
5,103 |
4,834 |
$905K |
| E0445 |
Oximeter non-invasive |
20,443 |
13,523 |
$875K |
| T4541 |
Large disposable underpad |
10,391 |
9,929 |
$709K |
| B9002 |
Enter nutr inf pump any type |
15,033 |
8,835 |
$701K |
| E0482 |
Cough stimulating device |
2,552 |
2,183 |
$692K |
| B4153 |
Ef hydrolyzed/amino acids |
1,450 |
1,357 |
$652K |
| T4530 |
Ped size brief/diaper lg |
5,040 |
4,869 |
$633K |
| A6211 |
Foam drg > 48 sq in w/o brdr |
2,323 |
2,196 |
$631K |
| T4522 |
Adult size brief/diaper med |
4,431 |
4,172 |
$475K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
10,765 |
9,664 |
$466K |
| A7000 |
Disposable canister for pump |
36,598 |
35,190 |
$458K |
| A6402 |
Sterile gauze <= 16 sq in |
30,797 |
28,949 |
$458K |
| A4649 |
Surgical supplies |
16,959 |
15,529 |
$457K |
| A4927 |
Non-sterile gloves |
28,837 |
27,648 |
$422K |
| E0601 |
Cont airway pressure device |
11,033 |
5,392 |
$379K |
| B4150 |
Ef complet w/intact nutrient |
2,023 |
1,917 |
$367K |
| B4154 |
Ef spec metabolic noninherit |
1,106 |
1,034 |
$335K |
| T4521 |
Adult size brief/diaper sm |
3,743 |
3,582 |
$328K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
4,306 |
4,110 |
$305K |
| E0600 |
Suction pump portab hom modl |
18,245 |
9,616 |
$303K |
| E0471 |
Rad w/backup non inv intrfc |
875 |
847 |
$285K |
| A4216 |
Sterile water/saline, 10 ml |
14,435 |
13,870 |
$239K |
| E0443 |
Portable 02 contents, gas |
3,161 |
3,053 |
$223K |
| A7002 |
Tubing used w suction pump |
37,046 |
35,425 |
$214K |
| A4452 |
Waterproof tape |
30,782 |
28,815 |
$211K |
| B4158 |
Ef ped complete intact nut |
2,148 |
1,948 |
$194K |
| E0562 |
Humidifier heated used w pap |
12,090 |
6,809 |
$192K |
| E1399 |
Durable medical equipment mi |
1,237 |
1,004 |
$186K |
| A4623 |
Tracheostomy inner cannula |
1,542 |
1,372 |
$178K |
| A6257 |
Transparent film <= 16 sq in |
10,904 |
9,758 |
$170K |
| B4152 |
Ef calorie dense>/=1.5kcal |
918 |
855 |
$167K |
| B4034 |
Enter feed supkit syr by day |
1,303 |
1,172 |
$159K |
| T4527 |
Adult size pull-on lg |
1,088 |
1,033 |
$147K |
| A6212 |
Foam drg <=16 sq in w/border |
1,465 |
1,359 |
$142K |
| A7018 |
Water distilled w/nebulizer |
29,555 |
28,388 |
$139K |
| A4322 |
Irrigation syringe |
15,060 |
13,959 |
$121K |
| E0565 |
Compressor air power source |
4,898 |
3,197 |
$114K |
| B4155 |
Ef incomplete/modular |
3,248 |
3,075 |
$103K |
| A9999 |
Dme supply or accessory, nos |
3,582 |
3,444 |
$101K |
| E0470 |
Rad w/o backup non-inv intfc |
812 |
515 |
$101K |
| A7003 |
Nebulizer administration set |
28,795 |
27,415 |
$99K |
| E0570 |
Nebulizer with compression |
1,223 |
1,107 |
$91K |
| A4213 |
20+ cc syringe only |
12,763 |
11,801 |
$91K |
| T4535 |
Disposable liner/shield/pad |
1,804 |
1,721 |
$82K |
| E0776 |
Iv pole |
11,472 |
8,161 |
$66K |
| A4351 |
Straight tip urine catheter |
653 |
608 |
$63K |
| B4036 |
Enteral feed sup kit grav by |
365 |
346 |
$59K |
| A4628 |
Oropharyngeal suction cath |
31,753 |
30,275 |
$57K |
| E0260 |
Hosp bed semi-electr w/ matt |
813 |
658 |
$55K |
| A7034 |
Nasal application device |
559 |
531 |
$54K |
| A6251 |
Absorpt drg <=16 sq in w/o b |
1,397 |
1,370 |
$53K |
| A6216 |
Non-sterile gauze<=16 sq in |
12,298 |
11,897 |
$49K |
| T4523 |
Adult size brief/diaper lg |
422 |
407 |
$48K |
| A4606 |
Oxygen probe used w oximeter |
789 |
687 |
$40K |
| E0550 |
Humidif extens supple w ippb |
1,927 |
1,337 |
$39K |
| A7035 |
Pos airway press headgear |
1,190 |
1,109 |
$38K |
| A7012 |
Nebulizer water collec devic |
6,243 |
5,983 |
$34K |
| A7037 |
Pos airway pressure tubing |
935 |
875 |
$31K |
| A4217 |
Sterile water/saline, 500 ml |
2,448 |
2,234 |
$30K |
| A4332 |
Lube sterile packet |
9,315 |
8,689 |
$29K |
| A7032 |
Replacement nasal cushion |
854 |
811 |
$29K |
| E0441 |
Stationary o2 contents, gas |
430 |
415 |
$27K |
| A4450 |
Non-waterproof tape |
6,189 |
5,969 |
$27K |
| A7013 |
Disposable compressor filter |
21,450 |
20,179 |
$25K |
| A7525 |
Tracheostomy mask |
11,584 |
11,177 |
$24K |
| T4532 |
Ped size pull-on lg |
255 |
235 |
$23K |
| L8501 |
Tracheostomy speaking valve |
364 |
361 |
$22K |
| A4344 |
Cath indw foley 2 way silicn |
1,410 |
1,345 |
$20K |
| A7046 |
Repl water chamber, pap dev |
1,228 |
1,146 |
$19K |
| B4082 |
Enteral ng tubing w/o stylet |
1,783 |
1,545 |
$18K |
| B9998 |
Enteral supp not otherwise c |
1,532 |
1,267 |
$17K |
| A6457 |
Tubular dressing |
253 |
239 |
$16K |
| T4524 |
Adult size brief/diaper xl |
101 |
88 |
$16K |
| E1392 |
Portable oxygen concentrator |
521 |
441 |
$14K |
| A7527 |
Trach/laryn tube plug/stop |
1,692 |
1,611 |
$14K |
| A4353 |
Intermittent urinary cath |
13 |
12 |
$13K |
| E0555 |
Humidifier for use w/ regula |
6,982 |
6,625 |
$12K |
| A7020 |
Interface, cough stim device |
873 |
845 |
$11K |
| E0630 |
Patient lift hydraulic |
141 |
141 |
$10K |
| A7030 |
Cpap full face mask |
64 |
55 |
$10K |
| A7015 |
Aerosol mask used w nebulize |
7,163 |
6,592 |
$10K |
| A7005 |
Nondisposable nebulizer set |
522 |
473 |
$10K |
| K0462 |
Temporary replacement eqpmnt |
187 |
180 |
$9K |
| A7038 |
Pos airway pressure filter |
1,830 |
1,707 |
$7K |
| A7010 |
Disposable corrugated tubing |
383 |
363 |
$7K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
67 |
65 |
$5K |
| A7039 |
Filter, non disposable w pap |
353 |
333 |
$4K |
| E0425 |
Gas system stationary compre |
39 |
39 |
$3K |
| A7031 |
Replacement facemask interfa |
61 |
52 |
$3K |
| A7007 |
Lg vol nebulizer disposable |
826 |
766 |
$3K |
| T4529 |
Ped size brief/diaper sm/med |
13 |
13 |
$1K |
| A4371 |
Skin barrier powder per oz |
291 |
248 |
$1K |
| A4554 |
Disposable underpads |
121 |
120 |
$194.60 |
| A5200 |
Percutaneous catheter anchor |
14 |
14 |
$154.86 |
| A4218 |
Sterile saline or water |
584 |
509 |
$149.04 |
| A6450 |
Lt compres band >=5"/yd |
49 |
49 |
$130.15 |
| A5120 |
Skin barrier, wipe or swab |
13 |
12 |
$70.50 |
| A4520 |
Incontinence garment anytype |
403 |
354 |
$0.00 |
| E0424 |
Stationary compressed gas 02 |
50 |
44 |
$0.00 |