| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home vent invasive interface |
4,940 |
4,434 |
$3.94M |
| E1390 |
Oxygen concentrator |
42,929 |
41,588 |
$3.01M |
| A4239 |
Non-adju cgm supply allow |
5,667 |
5,607 |
$1.11M |
| E0601 |
Cont airway pressure device |
23,884 |
23,602 |
$997K |
| B4150 |
Ef complet w/intact nutrient |
8,000 |
7,808 |
$911K |
| E0603 |
Electric breast pump |
5,565 |
5,555 |
$691K |
| E1399 |
Durable medical equipment mi |
1,371 |
1,272 |
$678K |
| B4035 |
Enteral feed supp pump per d |
3,745 |
3,323 |
$593K |
| E0466 |
Home vent non-invasive inter |
852 |
832 |
$513K |
| E0570 |
Nebulizer with compression |
11,741 |
11,412 |
$478K |
| E0445 |
Oximeter non-invasive |
1,676 |
1,644 |
$395K |
| E0470 |
Rad w/o backup non-inv intfc |
4,956 |
4,827 |
$387K |
| E0431 |
Portable gaseous 02 |
23,914 |
23,735 |
$382K |
| K0003 |
Lightweight wheelchair |
9,512 |
9,438 |
$346K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,418 |
2,272 |
$345K |
| E0260 |
Hosp bed semi-electr w/ matt |
7,465 |
7,397 |
$283K |
| A7030 |
Cpap full face mask |
4,801 |
4,671 |
$262K |
| E0562 |
Humidifier heated used w pap |
3,506 |
3,385 |
$258K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,430 |
2,359 |
$241K |
| B4087 |
Gastro/jejuno tube, std |
7,567 |
4,080 |
$233K |
| E0143 |
Walker folding wheeled w/o s |
3,923 |
3,888 |
$171K |
| E2103 |
Non-adju cgm receiver/mon |
782 |
772 |
$148K |
| A7034 |
Nasal application device |
4,247 |
4,102 |
$141K |
| A4230 |
Infus insulin pump non needl |
859 |
851 |
$134K |
| E0471 |
Rad w/backup non inv intrfc |
625 |
619 |
$130K |
| B9002 |
Enter nutr inf pump any type |
2,028 |
1,996 |
$121K |
| A4627 |
Spacer bag/reservoir |
10,072 |
9,983 |
$116K |
| B4152 |
Ef calorie dense>/=1.5kcal |
987 |
926 |
$115K |
| A6530 |
Compression stocking bk18-30 |
2,318 |
2,166 |
$114K |
| A7005 |
Nondisposable nebulizer set |
7,053 |
6,947 |
$104K |
| A7037 |
Pos airway pressure tubing |
5,938 |
5,742 |
$102K |
| A7035 |
Pos airway press headgear |
7,084 |
6,767 |
$100K |
| K0004 |
High strength ltwt whlchr |
1,470 |
1,466 |
$97K |
| T4534 |
Youth size pull-on |
784 |
735 |
$94K |
| A4624 |
Tracheal suction tube |
740 |
697 |
$87K |
| S8189 |
Trach supply noc |
490 |
461 |
$81K |
| E0971 |
Wheelchair anti-tipping devi |
2,530 |
2,118 |
$80K |
| A7031 |
Replacement facemask interfa |
3,265 |
2,964 |
$79K |
| A4351 |
Straight tip urine catheter |
851 |
778 |
$79K |
| B4100 |
Food thickener oral |
545 |
505 |
$77K |
| A4670 |
Automatic bp monitor, dial |
1,618 |
1,613 |
$77K |
| B4161 |
Ef ped hydrolyzed/amino acid |
199 |
188 |
$76K |
| A4253 |
Blood glucose/reagent strips |
2,391 |
2,329 |
$71K |
| A4385 |
Ost skn barrier sld ext wear |
1,440 |
1,357 |
$64K |
| L3908 |
Who cock-up nonmolde pre ots |
1,290 |
1,219 |
$61K |
| E0973 |
W/ch access det adj armrest |
1,911 |
1,536 |
$59K |
| A7526 |
Tracheostomy tube collar |
1,142 |
1,102 |
$59K |
| E0630 |
Patient lift hydraulic |
1,752 |
1,746 |
$58K |
| K0001 |
Standard wheelchair |
4,213 |
4,191 |
$54K |
| L4361 |
Pneuma/vac walk boot pre ots |
355 |
353 |
$52K |
| A4409 |
Ost skn barr convex <=4 sq i |
997 |
949 |
$51K |
| B4034 |
Enter feed supkit syr by day |
1,104 |
1,052 |
$48K |
| A7520 |
Trach/laryn tube non-cuffed |
809 |
775 |
$46K |
| E0784 |
Ext amb infusn pump insulin |
18 |
17 |
$46K |
| T4528 |
Adult size pull-on xl |
377 |
348 |
$45K |
| A7038 |
Pos airway pressure filter |
8,758 |
8,294 |
$44K |
| A4927 |
Non-sterile gloves |
2,128 |
2,048 |
$41K |
| A4232 |
Syringe w/needle insulin 3cc |
940 |
933 |
$40K |
| T4526 |
Adult size pull-on med |
335 |
322 |
$34K |
| A7032 |
Replacement nasal cushion |
1,346 |
1,204 |
$33K |
| T4527 |
Adult size pull-on lg |
274 |
263 |
$31K |
| E0149 |
Heavy duty wheeled walker |
1,438 |
1,389 |
$31K |
| A4606 |
Oxygen probe used w oximeter |
202 |
191 |
$30K |
| E0600 |
Suction pump portab hom modl |
865 |
849 |
$29K |
| T4535 |
Disposable liner/shield/pad |
676 |
643 |
$28K |
| E0156 |
Walker seat attachment |
2,977 |
2,952 |
$25K |
| K0007 |
Extra heavy duty wheelchair |
535 |
535 |
$25K |
| A4629 |
Tracheostomy care kit |
352 |
344 |
$25K |
| E0619 |
Apnea monitor w recorder |
146 |
139 |
$25K |
| E0482 |
Cough stimulating device |
92 |
92 |
$24K |
| T4541 |
Large disposable underpad |
821 |
788 |
$23K |
| K0195 |
Elevating whlchair leg rests |
3,276 |
3,225 |
$23K |
| K0108 |
W/c component-accessory nos |
163 |
105 |
$22K |
| S5199 |
Personal care item nos each |
1,386 |
1,326 |
$22K |
| A7033 |
Replacement nasal pillows |
1,050 |
909 |
$22K |
| K0739 |
Repair/svc dme non-oxygen eq |
297 |
291 |
$22K |
| E0114 |
Crutch underarm pair no wood |
861 |
858 |
$20K |
| A4604 |
Tubing with heating element |
2,096 |
2,082 |
$19K |
| E0951 |
Loop heel |
1,367 |
1,177 |
$17K |
| A4425 |
Ost pch drain for barrier fl |
355 |
341 |
$16K |
| A7046 |
Repl water chamber, pap dev |
3,221 |
3,164 |
$15K |
| E1028 |
W/c manual swingaway |
215 |
113 |
$15K |
| E0776 |
Iv pole |
1,735 |
1,723 |
$12K |
| K0823 |
Pwc gp 2 std cap chair |
160 |
158 |
$12K |
| K0553 |
Ther cgm supply allowance |
197 |
195 |
$11K |
| A7000 |
Disposable canister for pump |
1,581 |
1,542 |
$11K |
| A7015 |
Aerosol mask used w nebulize |
9,749 |
9,563 |
$11K |
| E0303 |
Hosp bed hvy dty xtra wide |
169 |
166 |
$11K |
| E0607 |
Blood glucose monitor home |
313 |
310 |
$10K |
| E0163 |
Commode chair with fixed arm |
611 |
609 |
$9K |
| E0730 |
Tens four lead |
305 |
305 |
$9K |
| A5514 |
Mult den insert dir carv/cam |
125 |
94 |
$9K |
| A6533 |
Gc stocking thighlngth 18-30 |
103 |
101 |
$9K |
| A6402 |
Sterile gauze <= 16 sq in |
1,311 |
1,196 |
$8K |
| A5063 |
Drain ostomy pouch w/flange |
243 |
233 |
$8K |
| E2601 |
Gen w/c cushion wdth < 22 in |
261 |
255 |
$7K |
| A4407 |
Ext wear ost skn barr <=4sq" |
117 |
112 |
$7K |
| A4259 |
Lancets per box |
1,857 |
1,823 |
$7K |
| A7002 |
Tubing used w suction pump |
1,054 |
1,036 |
$6K |
| A4595 |
Tens suppl 2 lead per month |
396 |
370 |
$6K |
| A5500 |
Diab shoe for density insert |
103 |
82 |
$5K |
| E1020 |
Residual limb support system |
331 |
298 |
$5K |
| B4082 |
Enteral ng tubing w/o stylet |
165 |
156 |
$5K |
| E1236 |
Folding ped wc adjustable |
25 |
25 |
$5K |
| A4450 |
Non-waterproof tape |
933 |
882 |
$5K |
| E0978 |
W/c acc,saf belt pelv strap |
227 |
223 |
$5K |
| A4357 |
Bedside drainage bag |
828 |
784 |
$4K |
| A6446 |
Conform band s w>=3" <5"/yd |
309 |
288 |
$4K |
| A7003 |
Nebulizer administration set |
4,576 |
4,474 |
$4K |
| E0250 |
Hosp bed fixed ht w/ mattres |
199 |
199 |
$4K |
| A5120 |
Skin barrier, wipe or swab |
430 |
385 |
$3K |
| L1820 |
Ko elas w/ condyle pads & jo |
37 |
36 |
$3K |
| A4623 |
Tracheostomy inner cannula |
54 |
50 |
$2K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
46 |
38 |
$2K |
| A7013 |
Disposable compressor filter |
2,870 |
2,764 |
$2K |
| L4350 |
Ankle control ortho pre ots |
34 |
34 |
$2K |
| A4394 |
Ostomy pouch liq deodorant |
79 |
75 |
$2K |
| E2209 |
Arm trough each |
171 |
170 |
$2K |
| L3809 |
Whfo w/o joints pre ots |
12 |
12 |
$2K |
| A6216 |
Non-sterile gauze<=16 sq in |
163 |
157 |
$1K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
32 |
31 |
$1K |
| A4256 |
Calibrator solution/chips |
327 |
327 |
$1K |
| A4452 |
Waterproof tape |
67 |
64 |
$1K |
| A4322 |
Irrigation syringe |
111 |
99 |
$1K |
| E0955 |
Cushioned headrest |
12 |
12 |
$1K |
| E0181 |
Press pad alternating w/ pum |
147 |
147 |
$961.98 |
| A4358 |
Urinary leg or abdomen bag |
172 |
169 |
$815.56 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
25 |
25 |
$804.25 |
| A4402 |
Lubricant per ounce |
540 |
530 |
$617.73 |
| A4371 |
Skin barrier powder per oz |
104 |
102 |
$566.53 |
| E0255 |
Hospital bed var ht w/ mattr |
15 |
13 |
$416.09 |
| A4628 |
Oropharyngeal suction cath |
38 |
37 |
$365.34 |
| A4258 |
Lancet device each |
68 |
68 |
$232.12 |
| K0738 |
Portable gas oxygen system |
24 |
24 |
$184.07 |
| A6257 |
Transparent film <= 16 sq in |
16 |
12 |
$167.01 |
| E0100 |
Cane adjust/fixed with tip |
14 |
14 |
$127.09 |
| K0053 |
Elevate footrest articulate |
15 |
12 |
$106.48 |
| A7007 |
Lg vol nebulizer disposable |
16 |
15 |
$87.92 |
| A7012 |
Nebulizer water collec devic |
12 |
12 |
$46.52 |
| A7039 |
Filter, non disposable w pap |
12 |
12 |
$6.22 |