| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
118,477 |
79,884 |
$6.61M |
| E0465 |
Home vent invasive interface |
5,028 |
3,448 |
$3.21M |
| E0466 |
Home vent non-invasive inter |
6,112 |
4,288 |
$2.74M |
| K0738 |
Portable gas oxygen system |
59,461 |
40,897 |
$1.02M |
| B4035 |
Enteral feed supp pump per d |
8,801 |
4,387 |
$770K |
| A7030 |
Cpap full face mask |
16,567 |
11,449 |
$765K |
| E0601 |
Cont airway pressure device |
18,758 |
12,756 |
$564K |
| A4554 |
Disposable underpads |
12,813 |
8,351 |
$502K |
| B4152 |
Ef calorie dense>/=1.5kcal |
5,819 |
3,438 |
$498K |
| B4150 |
Ef complet w/intact nutrient |
4,269 |
2,964 |
$392K |
| T4527 |
Adult size pull-on lg |
3,937 |
2,533 |
$384K |
| A7031 |
Replacement facemask interfa |
20,824 |
12,664 |
$361K |
| B4161 |
Ef ped hydrolyzed/amino acid |
1,031 |
647 |
$361K |
| B4154 |
Ef spec metabolic noninherit |
2,264 |
1,719 |
$358K |
| E0260 |
Hosp bed semi-electr w/ matt |
16,919 |
11,233 |
$349K |
| E0445 |
Oximeter non-invasive |
2,428 |
1,934 |
$343K |
| E1392 |
Portable oxygen concentrator |
24,920 |
16,675 |
$340K |
| T4526 |
Adult size pull-on med |
2,885 |
1,992 |
$275K |
| E0143 |
Walker folding wheeled w/o s |
7,762 |
5,637 |
$264K |
| A4623 |
Tracheostomy inner cannula |
3,966 |
2,271 |
$250K |
| A7034 |
Nasal application device |
9,144 |
6,360 |
$248K |
| T4544 |
Adlt disp und/pull on abv xl |
1,660 |
1,069 |
$240K |
| B4034 |
Enter feed supkit syr by day |
5,167 |
2,844 |
$227K |
| A4624 |
Tracheal suction tube |
2,765 |
1,874 |
$214K |
| A4629 |
Tracheostomy care kit |
4,056 |
2,525 |
$212K |
| T4528 |
Adult size pull-on xl |
2,281 |
1,394 |
$209K |
| E0470 |
Rad w/o backup non-inv intfc |
2,829 |
1,897 |
$200K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
2,181 |
1,360 |
$190K |
| A7037 |
Pos airway pressure tubing |
15,141 |
10,465 |
$188K |
| A7035 |
Pos airway press headgear |
15,249 |
10,993 |
$175K |
| K0003 |
Lightweight wheelchair |
10,470 |
6,988 |
$173K |
| T4522 |
Adult size brief/diaper med |
1,958 |
1,259 |
$171K |
| E0163 |
Commode chair with fixed arm |
5,288 |
3,951 |
$158K |
| B9002 |
Enter nutr inf pump any type |
2,665 |
1,809 |
$154K |
| K0001 |
Standard wheelchair |
15,656 |
10,746 |
$153K |
| E0562 |
Humidifier heated used w pap |
2,027 |
1,411 |
$152K |
| E0431 |
Portable gaseous 02 |
11,852 |
8,378 |
$149K |
| T4523 |
Adult size brief/diaper lg |
1,443 |
981 |
$143K |
| B4153 |
Ef hydrolyzed/amino acids |
406 |
232 |
$140K |
| E0483 |
Hi freq chest wall oscil sys |
549 |
330 |
$138K |
| K0823 |
Pwc gp 2 std cap chair |
1,481 |
976 |
$135K |
| B4149 |
Ef blenderized foods |
380 |
230 |
$134K |
| E2402 |
Neg press wound therapy pump |
329 |
217 |
$124K |
| L8501 |
Tracheostomy speaking valve |
2,205 |
1,388 |
$113K |
| E0570 |
Nebulizer with compression |
12,165 |
7,859 |
$100K |
| T4535 |
Disposable liner/shield/pad |
1,929 |
1,509 |
$99K |
| A7038 |
Pos airway pressure filter |
33,109 |
21,923 |
$88K |
| S5165 |
Home modifications per serv |
72 |
65 |
$88K |
| K0007 |
Extra heavy duty wheelchair |
2,241 |
1,483 |
$88K |
| E0630 |
Patient lift hydraulic |
5,215 |
3,473 |
$87K |
| A7032 |
Replacement nasal cushion |
5,913 |
3,618 |
$87K |
| A7520 |
Trach/laryn tube non-cuffed |
3,504 |
2,128 |
$83K |
| E0277 |
Powered pres-redu air mattrs |
670 |
418 |
$80K |
| T4524 |
Adult size brief/diaper xl |
820 |
517 |
$79K |
| K0195 |
Elevating whlchair leg rests |
16,620 |
11,317 |
$79K |
| K0006 |
Heavy duty wheelchair |
3,245 |
2,139 |
$78K |
| A7526 |
Tracheostomy tube collar |
4,725 |
3,020 |
$77K |
| E2611 |
Gen use back cush wdth <22in |
1,175 |
832 |
$77K |
| E0247 |
Trans bench w/wo comm open |
1,286 |
910 |
$71K |
| B4155 |
Ef incomplete/modular |
1,108 |
692 |
$68K |
| E0240 |
Bath/shower chair |
1,720 |
1,275 |
$64K |
| B4088 |
Gastro/jejuno tube, low-pro |
854 |
549 |
$63K |
| A4604 |
Tubing with heating element |
8,622 |
6,844 |
$55K |
| E0303 |
Hosp bed hvy dty xtra wide |
1,212 |
833 |
$54K |
| A7033 |
Replacement nasal pillows |
4,758 |
3,045 |
$52K |
| E0600 |
Suction pump portab hom modl |
2,726 |
1,829 |
$51K |
| E0971 |
Wheelchair anti-tipping devi |
4,171 |
2,713 |
$49K |
| K0004 |
High strength ltwt whlchr |
2,157 |
1,541 |
$47K |
| A7000 |
Disposable canister for pump |
4,397 |
2,901 |
$46K |
| B9998 |
Enteral supp not otherwise c |
5,834 |
2,741 |
$44K |
| E0149 |
Heavy duty wheeled walker |
2,969 |
1,832 |
$43K |
| E0185 |
Gel pressure mattress pad |
1,337 |
997 |
$43K |
| T4525 |
Adult size pull-on sm |
478 |
302 |
$41K |
| T4534 |
Youth size pull-on |
317 |
246 |
$39K |
| E2601 |
Gen w/c cushion wdth < 22 in |
1,846 |
1,305 |
$35K |
| E0471 |
Rad w/backup non inv intrfc |
170 |
110 |
$33K |
| E0973 |
W/ch access det adj armrest |
1,626 |
967 |
$32K |
| E0114 |
Crutch underarm pair no wood |
1,207 |
868 |
$32K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
1,956 |
1,260 |
$29K |
| T4543 |
Adult disp brief/diap abv xl |
219 |
123 |
$29K |
| A7046 |
Repl water chamber, pap dev |
10,262 |
7,489 |
$26K |
| A4217 |
Sterile water/saline, 500 ml |
768 |
518 |
$26K |
| E0165 |
Commode chair with detacharm |
1,340 |
885 |
$24K |
| E0565 |
Compressor air power source |
863 |
605 |
$23K |
| E0168 |
Heavyduty/wide commode chair |
337 |
252 |
$22K |
| A7521 |
Trach/laryn tube cuffed |
1,255 |
714 |
$21K |
| A7005 |
Nondisposable nebulizer set |
1,951 |
1,348 |
$20K |
| T4521 |
Adult size brief/diaper sm |
191 |
108 |
$15K |
| E0156 |
Walker seat attachment |
2,495 |
1,748 |
$15K |
| E0961 |
Wheelchair brake extension |
1,725 |
1,023 |
$15K |
| E0776 |
Iv pole |
1,829 |
1,256 |
$13K |
| L3660 |
So 8 ab rstr can/web pre ots |
808 |
403 |
$13K |
| E1028 |
W/c manual swingaway |
528 |
276 |
$10K |
| E0271 |
Mattress innerspring |
1,135 |
643 |
$10K |
| A4628 |
Oropharyngeal suction cath |
2,590 |
1,789 |
$10K |
| A7002 |
Tubing used w suction pump |
3,654 |
2,462 |
$9K |
| A6550 |
Neg pres wound ther drsg set |
101 |
56 |
$9K |
| E0482 |
Cough stimulating device |
46 |
36 |
$8K |
| E0181 |
Press pad alternating w/ pum |
1,362 |
929 |
$8K |
| E0910 |
Trapeze bar attached to bed |
1,174 |
853 |
$5K |
| A7007 |
Lg vol nebulizer disposable |
1,649 |
1,074 |
$5K |
| E2202 |
Seat width 24-27 in |
439 |
232 |
$5K |
| L4361 |
Pneuma/vac walk boot pre ots |
247 |
112 |
$4K |
| A7012 |
Nebulizer water collec devic |
1,658 |
1,090 |
$4K |
| E0184 |
Dry pressure mattress |
865 |
541 |
$4K |
| E0261 |
Hosp bed semi-electr w/o mat |
738 |
493 |
$4K |
| E0912 |
Hd trapeze bar free standing |
239 |
143 |
$4K |
| A7010 |
Disposable corrugated tubing |
528 |
356 |
$4K |
| L1830 |
Ko immob canvas long pre ots |
189 |
97 |
$4K |
| A7525 |
Tracheostomy mask |
3,369 |
1,814 |
$3K |
| E1038 |
Transport chair pt wt<=300lb |
1,346 |
758 |
$3K |
| A4483 |
Moisture exchanger |
26 |
16 |
$3K |
| A7039 |
Filter, non disposable w pap |
752 |
534 |
$3K |
| E0265 |
Hosp bed total electr w/ mat |
24 |
13 |
$2K |
| L1902 |
Afo ankle gauntlet pre ots |
89 |
55 |
$2K |
| A7507 |
Integrated filter & holder |
558 |
341 |
$2K |
| A4450 |
Non-waterproof tape |
382 |
234 |
$2K |
| T4533 |
Youth size brief/diaper |
37 |
15 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
193 |
156 |
$2K |
| E0621 |
Patient lift sling or seat |
121 |
67 |
$2K |
| A7036 |
Pos airway press chinstrap |
412 |
288 |
$2K |
| L3908 |
Who cock-up nonmolde pre ots |
170 |
79 |
$1K |
| T4530 |
Ped size brief/diaper lg |
21 |
12 |
$1K |
| L3260 |
Ambulatory surgical boot eac |
70 |
41 |
$1K |
| E1226 |
Manual fully reclining back |
73 |
49 |
$1K |
| E0705 |
Transfer device |
51 |
37 |
$1K |
| E1399 |
Durable medical equipment mi |
231 |
184 |
$1K |
| E0940 |
Trapeze bar free standing |
186 |
104 |
$943.39 |
| A4606 |
Oxygen probe used w oximeter |
235 |
134 |
$889.62 |
| A7015 |
Aerosol mask used w nebulize |
792 |
563 |
$838.93 |
| A4927 |
Non-sterile gloves |
96 |
66 |
$772.64 |
| A9270 |
Non-covered item or service |
107 |
88 |
$763.54 |
| E0978 |
W/c acc,saf belt pelv strap |
40 |
29 |
$695.18 |
| L4350 |
Ankle control ortho pre ots |
28 |
13 |
$682.11 |
| L1812 |
Ko elastic w/joints pre ots |
64 |
28 |
$565.34 |
| A7013 |
Disposable compressor filter |
1,775 |
1,207 |
$486.31 |
| K0052 |
Swingaway detach ftrest repl |
181 |
126 |
$484.62 |
| E0135 |
Walker folding adjust/fixed |
14 |
12 |
$467.93 |
| W4211 |
|
1,183 |
915 |
$463.73 |
| E0105 |
Cane adjust/fixed quad/3 pro |
13 |
12 |
$364.72 |
| E0245 |
Tub stool or bench |
226 |
173 |
$328.74 |
| K0825 |
Pwc gp 2 hd cap chair |
19 |
12 |
$308.44 |
| S8120 |
O2 contents gas cubic ft |
31 |
25 |
$260.53 |
| A4322 |
Irrigation syringe |
20 |
13 |
$244.02 |
| A6402 |
Sterile gauze <= 16 sq in |
455 |
271 |
$199.82 |
| A4452 |
Waterproof tape |
28 |
16 |
$168.14 |
| E0434 |
Portable liquid 02 |
23 |
12 |
$133.33 |
| A7003 |
Nebulizer administration set |
121 |
66 |
$108.03 |
| A5120 |
Skin barrier, wipe or swab |
25 |
12 |
$62.70 |
| A4216 |
Sterile water/saline, 10 ml |
307 |
186 |
$40.80 |
| A6216 |
Non-sterile gauze<=16 sq in |
22 |
16 |
$37.00 |
| W4212 |
|
34 |
26 |
$34.02 |
| A7504 |
Tracheostoma hmes filter |
83 |
50 |
$32.02 |
| A7509 |
Heat & moisture exchange sys |
184 |
133 |
$29.05 |
| A7020 |
Interface, cough stim device |
21 |
12 |
$21.60 |
| A4618 |
Breathing circuits |
51 |
30 |
$15.03 |
| A4615 |
Cannula nasal |
95 |
41 |
$11.74 |
| XZERO |
|
1,072 |
794 |
$6.99 |
| E0305 |
Rails bed side half length |
110 |
68 |
$5.04 |
| A4520 |
Incontinence garment anytype |
23 |
12 |
$4.88 |
| E0310 |
Rails bed side full length |
25 |
12 |
$0.00 |
| A6403 |
Sterile gauze>16 <= 48 sq in |
52 |
15 |
$0.00 |