| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
2,518 |
2,373 |
$5.90M |
| E0465 |
Home vent invasive interface |
1,747 |
1,645 |
$3.50M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
11,223 |
9,378 |
$2.03M |
| E0445 |
Oximeter non-invasive |
5,734 |
5,428 |
$1.71M |
| E1390 |
Oxygen concentrator |
4,998 |
4,607 |
$1.49M |
| E0424 |
Stationary compressed gas 02 |
4,302 |
4,105 |
$1.32M |
| E0471 |
Rad w/backup non inv intrfc |
2,190 |
2,033 |
$1.09M |
| E1399 |
Durable medical equipment mi |
2,676 |
2,135 |
$924K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
2,504 |
2,053 |
$769K |
| A4483 |
Moisture exchanger |
2,017 |
1,580 |
$677K |
| E0431 |
Portable gaseous 02 |
8,903 |
8,454 |
$621K |
| E0562 |
Humidifier heated used w pap |
5,630 |
4,839 |
$575K |
| A4624 |
Tracheal suction tube |
2,241 |
1,912 |
$545K |
| A4606 |
Oxygen probe used w oximeter |
7,434 |
6,940 |
$441K |
| A7520 |
Trach/laryn tube non-cuffed |
860 |
799 |
$347K |
| A7034 |
Nasal application device |
2,200 |
2,098 |
$329K |
| B4161 |
Ef ped hydrolyzed/amino acid |
852 |
780 |
$302K |
| E0601 |
Cont airway pressure device |
2,161 |
2,116 |
$299K |
| A7521 |
Trach/laryn tube cuffed |
675 |
622 |
$292K |
| E0565 |
Compressor air power source |
1,332 |
1,237 |
$276K |
| E0439 |
Stationary liquid 02 |
1,080 |
1,001 |
$275K |
| B4088 |
Gastro/jejuno tube, low-pro |
3,337 |
3,134 |
$265K |
| A6212 |
Foam drg <=16 sq in w/border |
1,036 |
930 |
$265K |
| A4351 |
Straight tip urine catheter |
1,344 |
1,214 |
$253K |
| A4605 |
Trach suction cath close sys |
763 |
645 |
$235K |
| E1240 |
Whchr litwt det arm leg rest |
2,013 |
1,989 |
$225K |
| E0482 |
Cough stimulating device |
709 |
678 |
$197K |
| A7000 |
Disposable canister for pump |
3,911 |
3,734 |
$182K |
| E1150 |
Wheelchair standard w/ leg r |
2,018 |
1,913 |
$143K |
| E0570 |
Nebulizer with compression |
619 |
597 |
$133K |
| B4150 |
Ef complet w/intact nutrient |
1,335 |
1,123 |
$127K |
| B4152 |
Ef calorie dense>/=1.5kcal |
956 |
815 |
$126K |
| E0470 |
Rad w/o backup non-inv intfc |
824 |
781 |
$116K |
| A4217 |
Sterile water/saline, 500 ml |
2,477 |
2,207 |
$115K |
| A7526 |
Tracheostomy tube collar |
1,259 |
1,173 |
$110K |
| A4385 |
Ost skn barrier sld ext wear |
779 |
708 |
$96K |
| A7035 |
Pos airway press headgear |
2,049 |
1,973 |
$87K |
| E0600 |
Suction pump portab hom modl |
2,251 |
2,066 |
$84K |
| A7037 |
Pos airway pressure tubing |
1,807 |
1,763 |
$84K |
| A4618 |
Breathing circuits |
1,644 |
1,325 |
$73K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
543 |
490 |
$72K |
| E0260 |
Hosp bed semi-electr w/ matt |
404 |
388 |
$71K |
| A7005 |
Nondisposable nebulizer set |
1,525 |
1,475 |
$69K |
| B4162 |
Ef ped specmetabolic inherit |
443 |
404 |
$67K |
| E0434 |
Portable liquid 02 |
1,014 |
959 |
$48K |
| A7045 |
Repl exhalation port for pap |
457 |
439 |
$42K |
| A4927 |
Non-sterile gloves |
1,717 |
1,461 |
$40K |
| B4103 |
Ef ped fluid and electrolyte |
608 |
494 |
$39K |
| A6216 |
Non-sterile gauze<=16 sq in |
2,603 |
2,413 |
$37K |
| A4450 |
Non-waterproof tape |
6,477 |
6,160 |
$37K |
| E0143 |
Walker folding wheeled w/o s |
263 |
261 |
$36K |
| E1060 |
Wheelchair detachable arms |
422 |
405 |
$35K |
| A4425 |
Ost pch drain for barrier fl |
335 |
297 |
$33K |
| E1140 |
Wheelchair standard detach a |
370 |
364 |
$33K |
| A7003 |
Nebulizer administration set |
2,860 |
2,750 |
$26K |
| A7038 |
Pos airway pressure filter |
2,451 |
2,267 |
$25K |
| A7046 |
Repl water chamber, pap dev |
911 |
888 |
$25K |
| B4155 |
Ef incomplete/modular |
594 |
558 |
$23K |
| A6402 |
Sterile gauze <= 16 sq in |
2,013 |
1,799 |
$22K |
| A4628 |
Oropharyngeal suction cath |
1,032 |
968 |
$21K |
| A7015 |
Aerosol mask used w nebulize |
3,052 |
2,933 |
$15K |
| A5120 |
Skin barrier, wipe or swab |
772 |
730 |
$14K |
| E0481 |
Intrpulmnry percuss vent sys |
49 |
48 |
$13K |
| A4626 |
Tracheostomy cleaning brush |
941 |
898 |
$13K |
| A4357 |
Bedside drainage bag |
256 |
248 |
$13K |
| A4649 |
Surgical supplies |
947 |
408 |
$10K |
| A4627 |
Spacer bag/reservoir |
573 |
563 |
$10K |
| A4620 |
Variable concentration mask |
1,632 |
1,553 |
$9K |
| K0003 |
Lightweight wheelchair |
94 |
92 |
$7K |
| A4213 |
20+ cc syringe only |
1,108 |
1,065 |
$6K |
| E0163 |
Commode chair with fixed arm |
65 |
65 |
$5K |
| A6257 |
Transparent film <= 16 sq in |
104 |
98 |
$5K |
| A4406 |
Pectin based ostomy paste |
371 |
340 |
$4K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
27 |
24 |
$4K |
| A4215 |
Sterile needle |
955 |
924 |
$3K |
| A4245 |
Alcohol wipes per box |
813 |
786 |
$3K |
| A4371 |
Skin barrier powder per oz |
389 |
373 |
$2K |
| A4615 |
Cannula nasal |
938 |
846 |
$2K |
| A4452 |
Waterproof tape |
368 |
346 |
$2K |
| E0247 |
Trans bench w/wo comm open |
14 |
14 |
$1K |
| E0630 |
Patient lift hydraulic |
12 |
12 |
$1K |
| E0271 |
Mattress innerspring |
227 |
215 |
$736.55 |
| A4367 |
Ostomy belt |
93 |
88 |
$514.48 |
| E0621 |
Patient lift sling or seat |
40 |
38 |
$359.07 |