| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
25,603 |
22,673 |
$2.36M |
| B4035 |
Enteral feed supp pump per d |
10,792 |
7,881 |
$1.63M |
| E0465 |
Home vent invasive interface |
2,161 |
1,382 |
$1.01M |
| B4161 |
Ef ped hydrolyzed/amino acid |
2,399 |
1,746 |
$956K |
| B9998 |
Enteral supp not otherwise c |
12,092 |
8,315 |
$733K |
| E0570 |
Nebulizer with compression |
11,480 |
10,289 |
$617K |
| A7030 |
Cpap full face mask |
5,288 |
4,728 |
$536K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
4,324 |
3,032 |
$507K |
| E0445 |
Oximeter non-invasive |
2,110 |
1,789 |
$496K |
| B4088 |
Gastro/jejuno tube, low-pro |
3,432 |
3,044 |
$480K |
| E0601 |
Cont airway pressure device |
6,498 |
5,640 |
$479K |
| B4149 |
Ef blenderized foods |
2,053 |
1,310 |
$459K |
| A7031 |
Replacement facemask interfa |
6,869 |
6,210 |
$448K |
| K0738 |
Portable gas oxygen system |
12,344 |
11,206 |
$306K |
| T4530 |
Ped size brief/diaper lg |
1,794 |
1,634 |
$305K |
| T4522 |
Adult size brief/diaper med |
2,036 |
1,708 |
$258K |
| B9002 |
Enter nutr inf pump any type |
2,551 |
2,086 |
$242K |
| T4534 |
Youth size pull-on |
1,884 |
1,675 |
$185K |
| A7034 |
Nasal application device |
4,111 |
3,763 |
$183K |
| L3809 |
Whfo w/o joints pre ots |
1,459 |
1,347 |
$181K |
| E0470 |
Rad w/o backup non-inv intfc |
1,516 |
1,293 |
$166K |
| A4351 |
Straight tip urine catheter |
1,507 |
1,208 |
$159K |
| A7038 |
Pos airway pressure filter |
9,360 |
8,383 |
$158K |
| A4606 |
Oxygen probe used w oximeter |
4,235 |
2,588 |
$146K |
| B4036 |
Enteral feed sup kit grav by |
1,245 |
1,061 |
$145K |
| B4150 |
Ef complet w/intact nutrient |
1,833 |
1,389 |
$145K |
| E0114 |
Crutch underarm pair no wood |
4,134 |
4,011 |
$145K |
| E0562 |
Humidifier heated used w pap |
737 |
690 |
$143K |
| E0466 |
Home vent non-invasive inter |
767 |
320 |
$137K |
| A7032 |
Replacement nasal cushion |
3,171 |
2,902 |
$134K |
| E0431 |
Portable gaseous 02 |
5,937 |
5,510 |
$129K |
| A7035 |
Pos airway press headgear |
5,771 |
5,194 |
$126K |
| L3908 |
Who cock-up nonmolde pre ots |
3,076 |
2,756 |
$124K |
| L4386 |
Non-pneum walk boot pre cst |
1,109 |
1,054 |
$121K |
| A7033 |
Replacement nasal pillows |
2,255 |
2,102 |
$110K |
| A7005 |
Nondisposable nebulizer set |
4,492 |
4,271 |
$107K |
| E0143 |
Walker folding wheeled w/o s |
2,078 |
1,966 |
$103K |
| K0003 |
Lightweight wheelchair |
2,472 |
2,096 |
$101K |
| B4034 |
Enter feed supkit syr by day |
1,272 |
986 |
$99K |
| A4627 |
Spacer bag/reservoir |
3,374 |
3,284 |
$93K |
| E1399 |
Durable medical equipment mi |
4,024 |
1,883 |
$91K |
| L4361 |
Pneuma/vac walk boot pre ots |
447 |
426 |
$85K |
| K0001 |
Standard wheelchair |
3,651 |
3,160 |
$82K |
| A4624 |
Tracheal suction tube |
1,330 |
1,094 |
$79K |
| B4152 |
Ef calorie dense>/=1.5kcal |
796 |
579 |
$73K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,893 |
1,637 |
$65K |
| L4387 |
Non-pneum walk boot pre ots |
503 |
486 |
$62K |
| E0424 |
Stationary compressed gas 02 |
598 |
506 |
$62K |
| B4153 |
Ef hydrolyzed/amino acids |
137 |
107 |
$52K |
| A4385 |
Ost skn barrier sld ext wear |
1,197 |
964 |
$50K |
| A4554 |
Disposable underpads |
2,175 |
1,904 |
$46K |
| T4523 |
Adult size brief/diaper lg |
314 |
247 |
$42K |
| E0603 |
Electric breast pump |
152 |
152 |
$38K |
| E0600 |
Suction pump portab hom modl |
1,461 |
1,286 |
$37K |
| A7526 |
Tracheostomy tube collar |
1,807 |
1,488 |
$37K |
| E0619 |
Apnea monitor w recorder |
163 |
146 |
$36K |
| A7046 |
Repl water chamber, pap dev |
3,445 |
3,069 |
$35K |
| A4927 |
Non-sterile gloves |
2,409 |
1,986 |
$34K |
| A7000 |
Disposable canister for pump |
2,750 |
2,406 |
$33K |
| A5057 |
1 pc ost pou w built-in conv |
283 |
226 |
$33K |
| A7507 |
Integrated filter & holder |
704 |
527 |
$33K |
| A7002 |
Tubing used w suction pump |
3,677 |
2,621 |
$27K |
| E0971 |
Wheelchair anti-tipping devi |
11,147 |
4,817 |
$24K |
| A4629 |
Tracheostomy care kit |
572 |
502 |
$23K |
| A4628 |
Oropharyngeal suction cath |
2,177 |
1,780 |
$21K |
| T4526 |
Adult size pull-on med |
229 |
212 |
$20K |
| A4222 |
Infusion supplies with pump |
283 |
55 |
$19K |
| E0630 |
Patient lift hydraulic |
387 |
324 |
$19K |
| T4535 |
Disposable liner/shield/pad |
658 |
539 |
$18K |
| A4407 |
Ext wear ost skn barr <=4sq" |
281 |
208 |
$18K |
| T4521 |
Adult size brief/diaper sm |
182 |
141 |
$17K |
| L3260 |
Ambulatory surgical boot eac |
1,039 |
947 |
$17K |
| A7037 |
Pos airway pressure tubing |
4,389 |
3,981 |
$15K |
| A4483 |
Moisture exchanger |
178 |
146 |
$15K |
| A7520 |
Trach/laryn tube non-cuffed |
374 |
283 |
$13K |
| E0990 |
Wheelchair elevating leg res |
1,919 |
920 |
$13K |
| A4604 |
Tubing with heating element |
5,339 |
4,763 |
$12K |
| E0202 |
Phototherapy light w/ photom |
25 |
24 |
$11K |
| E0978 |
W/c acc,saf belt pelv strap |
5,589 |
4,674 |
$11K |
| K0004 |
High strength ltwt whlchr |
104 |
97 |
$9K |
| A4565 |
Slings |
1,437 |
1,405 |
$8K |
| A4362 |
Solid skin barrier |
224 |
190 |
$8K |
| E1392 |
Portable oxygen concentrator |
2,136 |
1,859 |
$6K |
| A7003 |
Nebulizer administration set |
2,119 |
1,956 |
$6K |
| A4216 |
Sterile water/saline, 10 ml |
765 |
551 |
$6K |
| A7015 |
Aerosol mask used w nebulize |
3,091 |
2,906 |
$5K |
| A4456 |
Adhesive remover, wipes |
602 |
534 |
$4K |
| K0052 |
Swingaway detach ftrest repl |
898 |
449 |
$4K |
| A4406 |
Pectin based ostomy paste |
574 |
495 |
$4K |
| A4217 |
Sterile water/saline, 500 ml |
348 |
216 |
$3K |
| A4357 |
Bedside drainage bag |
480 |
411 |
$3K |
| E1020 |
Residual limb support system |
87 |
78 |
$3K |
| K0053 |
Elevate footrest articulate |
142 |
117 |
$3K |
| A5063 |
Drain ostomy pouch w/flange |
83 |
65 |
$3K |
| T4525 |
Adult size pull-on sm |
32 |
26 |
$3K |
| A5120 |
Skin barrier, wipe or swab |
624 |
524 |
$3K |
| L1902 |
Afo ankle gauntlet pre ots |
40 |
38 |
$2K |
| T4537 |
Reusable underpad bed size |
38 |
36 |
$2K |
| A4221 |
Supp non-insulin inf cath/wk |
84 |
37 |
$2K |
| E0149 |
Heavy duty wheeled walker |
109 |
94 |
$2K |
| T4532 |
Ped size pull-on lg |
17 |
13 |
$1K |
| L4350 |
Ankle control ortho pre ots |
30 |
28 |
$1K |
| T4528 |
Adult size pull-on xl |
14 |
12 |
$1K |
| A4520 |
Incontinence garment anytype |
179 |
143 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
205 |
155 |
$1K |
| T4527 |
Adult size pull-on lg |
16 |
13 |
$1K |
| A4605 |
Trach suction cath close sys |
45 |
25 |
$899.43 |
| E0181 |
Press pad alternating w/ pum |
68 |
62 |
$767.34 |
| A4452 |
Waterproof tape |
119 |
71 |
$576.44 |
| A4425 |
Ost pch drain for barrier fl |
13 |
12 |
$478.03 |
| A4371 |
Skin barrier powder per oz |
142 |
122 |
$350.59 |
| L2999 |
Lower extremity orthosis nos |
32 |
26 |
$301.86 |
| A4394 |
Ostomy pouch liq deodorant |
13 |
12 |
$292.68 |
| E0156 |
Walker seat attachment |
43 |
40 |
$275.12 |
| E0973 |
W/ch access det adj armrest |
21 |
12 |
$255.67 |
| A4618 |
Breathing circuits |
41 |
24 |
$164.00 |
| E1028 |
W/c manual swingaway |
37 |
24 |
$122.81 |
| A4245 |
Alcohol wipes per box |
15 |
14 |
$76.10 |
| A4649 |
Surgical supplies |
16 |
12 |
$74.74 |
| A4209 |
5+ cc sterile syringe&needle |
41 |
16 |
$51.60 |
| A4481 |
Tracheostoma filter |
15 |
12 |
$10.74 |
| A4215 |
Sterile needle |
26 |
15 |
$8.14 |
| A4930 |
Sterile, gloves per pair |
103 |
88 |
$0.00 |