| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
135,171 |
126,951 |
$6.84M |
| E0601 |
Cont airway pressure device |
43,946 |
40,965 |
$1.01M |
| E0431 |
Portable gaseous 02 |
108,141 |
101,785 |
$1.01M |
| A7030 |
Cpap full face mask |
17,034 |
16,330 |
$882K |
| E0570 |
Nebulizer with compression |
19,008 |
17,964 |
$659K |
| A4351 |
Straight tip urine catheter |
4,428 |
3,800 |
$572K |
| E0465 |
Home vent invasive interface |
1,333 |
1,258 |
$472K |
| K0001 |
Standard wheelchair |
36,419 |
32,813 |
$420K |
| A7031 |
Replacement facemask interfa |
18,626 |
17,450 |
$415K |
| E0445 |
Oximeter non-invasive |
1,732 |
1,618 |
$389K |
| T4526 |
Adult size pull-on med |
5,985 |
5,654 |
$388K |
| E0562 |
Humidifier heated used w pap |
6,388 |
6,155 |
$350K |
| E0470 |
Rad w/o backup non-inv intfc |
7,051 |
6,618 |
$340K |
| E0260 |
Hosp bed semi-electr w/ matt |
16,718 |
14,631 |
$330K |
| E0240 |
Bath/shower chair |
1,006 |
986 |
$328K |
| E0466 |
Home vent non-invasive inter |
700 |
656 |
$298K |
| A7034 |
Nasal application device |
8,023 |
7,642 |
$263K |
| T4534 |
Youth size pull-on |
3,627 |
3,483 |
$253K |
| T4527 |
Adult size pull-on lg |
3,596 |
3,402 |
$243K |
| E0471 |
Rad w/backup non inv intrfc |
1,906 |
1,758 |
$226K |
| T4530 |
Ped size brief/diaper lg |
7,380 |
7,094 |
$220K |
| E0143 |
Walker folding wheeled w/o s |
8,380 |
7,941 |
$218K |
| A4624 |
Tracheal suction tube |
2,299 |
2,033 |
$181K |
| T4523 |
Adult size brief/diaper lg |
3,935 |
3,791 |
$169K |
| A7035 |
Pos airway press headgear |
15,940 |
15,191 |
$169K |
| A7037 |
Pos airway pressure tubing |
21,757 |
20,585 |
$164K |
| A7032 |
Replacement nasal cushion |
9,139 |
7,662 |
$164K |
| T4524 |
Adult size brief/diaper xl |
2,738 |
2,619 |
$160K |
| A4385 |
Ost skn barrier sld ext wear |
2,692 |
2,338 |
$141K |
| A4409 |
Ost skn barr convex <=4 sq i |
2,701 |
2,230 |
$135K |
| A7038 |
Pos airway pressure filter |
49,561 |
44,351 |
$125K |
| E0630 |
Patient lift hydraulic |
5,075 |
4,467 |
$103K |
| T4533 |
Youth size brief/diaper |
4,822 |
4,663 |
$97K |
| A4425 |
Ost pch drain for barrier fl |
2,912 |
2,442 |
$96K |
| T4522 |
Adult size brief/diaper med |
4,562 |
4,382 |
$96K |
| A4604 |
Tubing with heating element |
4,004 |
3,876 |
$94K |
| K0195 |
Elevating whlchair leg rests |
12,803 |
11,698 |
$90K |
| A4649 |
Surgical supplies |
3,314 |
2,500 |
$89K |
| T4528 |
Adult size pull-on xl |
1,093 |
1,041 |
$86K |
| E0600 |
Suction pump portab hom modl |
4,224 |
3,994 |
$85K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
5,063 |
3,957 |
$81K |
| A7526 |
Tracheostomy tube collar |
2,264 |
1,819 |
$80K |
| B4161 |
Ef ped hydrolyzed/amino acid |
2,553 |
2,143 |
$79K |
| K0108 |
W/c component-accessory nos |
1,634 |
877 |
$77K |
| E0277 |
Powered pres-redu air mattrs |
1,073 |
869 |
$74K |
| A7033 |
Replacement nasal pillows |
4,799 |
4,058 |
$74K |
| K0007 |
Extra heavy duty wheelchair |
1,869 |
1,685 |
$73K |
| A7005 |
Nondisposable nebulizer set |
9,704 |
9,255 |
$71K |
| K0003 |
Lightweight wheelchair |
3,596 |
3,278 |
$70K |
| T4543 |
Adult disp brief/diap abv xl |
440 |
428 |
$68K |
| A4629 |
Tracheostomy care kit |
1,273 |
1,132 |
$66K |
| A4407 |
Ext wear ost skn barr <=4sq" |
705 |
645 |
$64K |
| E0603 |
Electric breast pump |
815 |
809 |
$63K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,820 |
1,590 |
$54K |
| E0245 |
Tub stool or bench |
912 |
861 |
$53K |
| A4670 |
Automatic bp monitor, dial |
1,982 |
1,960 |
$51K |
| A4216 |
Sterile water/saline, 10 ml |
4,729 |
3,611 |
$51K |
| A7520 |
Trach/laryn tube non-cuffed |
1,117 |
1,025 |
$49K |
| T4544 |
Adlt disp und/pull on abv xl |
562 |
489 |
$47K |
| E1399 |
Durable medical equipment mi |
356 |
300 |
$46K |
| E1392 |
Portable oxygen concentrator |
4,618 |
4,373 |
$46K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
693 |
633 |
$44K |
| E0114 |
Crutch underarm pair no wood |
1,464 |
1,441 |
$44K |
| E0247 |
Trans bench w/wo comm open |
658 |
626 |
$41K |
| A4357 |
Bedside drainage bag |
5,786 |
4,609 |
$38K |
| K0823 |
Pwc gp 2 std cap chair |
143 |
102 |
$38K |
| E0265 |
Hosp bed total electr w/ mat |
902 |
790 |
$35K |
| A4362 |
Solid skin barrier |
557 |
490 |
$35K |
| A4623 |
Tracheostomy inner cannula |
538 |
466 |
$35K |
| A4349 |
Disposable male external cat |
1,259 |
1,031 |
$33K |
| A7046 |
Repl water chamber, pap dev |
5,146 |
4,907 |
$29K |
| A7039 |
Filter, non disposable w pap |
8,491 |
8,014 |
$28K |
| E0156 |
Walker seat attachment |
3,620 |
3,402 |
$27K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
424 |
361 |
$27K |
| A4352 |
Coude tip urinary catheter |
127 |
113 |
$26K |
| E0303 |
Hosp bed hvy dty xtra wide |
466 |
446 |
$25K |
| A6446 |
Conform band s w>=3" <5"/yd |
1,069 |
959 |
$24K |
| A4520 |
Incontinence garment anytype |
333 |
301 |
$21K |
| A5120 |
Skin barrier, wipe or swab |
3,930 |
3,321 |
$21K |
| A4358 |
Urinary leg or abdomen bag |
3,001 |
2,503 |
$21K |
| E0482 |
Cough stimulating device |
253 |
250 |
$21K |
| T4532 |
Ped size pull-on lg |
393 |
379 |
$20K |
| B4035 |
Enteral feed supp pump per d |
5,474 |
5,313 |
$19K |
| A4338 |
Indwelling catheter latex |
2,546 |
1,941 |
$18K |
| E0565 |
Compressor air power source |
638 |
587 |
$17K |
| E0181 |
Press pad alternating w/ pum |
2,822 |
2,446 |
$17K |
| E0971 |
Wheelchair anti-tipping devi |
5,690 |
5,237 |
$17K |
| A6212 |
Foam drg <=16 sq in w/border |
122 |
105 |
$17K |
| A4432 |
Os pch urine w bar/fange/tap |
402 |
359 |
$16K |
| E0163 |
Commode chair with fixed arm |
646 |
600 |
$15K |
| E0635 |
Patient lift electric |
442 |
409 |
$13K |
| A4310 |
Insert tray w/o bag/cath |
3,222 |
2,488 |
$12K |
| A5063 |
Drain ostomy pouch w/flange |
413 |
368 |
$12K |
| A6216 |
Non-sterile gauze<=16 sq in |
2,575 |
2,206 |
$11K |
| A4406 |
Pectin based ostomy paste |
1,062 |
918 |
$11K |
| A6402 |
Sterile gauze <= 16 sq in |
2,798 |
2,442 |
$11K |
| A4452 |
Waterproof tape |
1,580 |
1,221 |
$11K |
| E2601 |
Gen w/c cushion wdth < 22 in |
462 |
433 |
$11K |
| A7000 |
Disposable canister for pump |
2,607 |
2,335 |
$10K |
| A4606 |
Oxygen probe used w oximeter |
612 |
553 |
$10K |
| A7002 |
Tubing used w suction pump |
3,447 |
2,710 |
$10K |
| T4521 |
Adult size brief/diaper sm |
377 |
361 |
$9K |
| A5056 |
1 pc ost pouch w filter |
111 |
106 |
$9K |
| A4927 |
Non-sterile gloves |
817 |
636 |
$9K |
| B4150 |
Ef complet w/intact nutrient |
1,137 |
922 |
$9K |
| A4402 |
Lubricant per ounce |
1,404 |
1,211 |
$7K |
| E0550 |
Humidif extens supple w ippb |
748 |
734 |
$7K |
| E1038 |
Transport chair pt wt<=300lb |
1,272 |
1,154 |
$7K |
| E0149 |
Heavy duty wheeled walker |
94 |
89 |
$7K |
| A6449 |
Lt compres band >=3" <5"/yd |
184 |
176 |
$7K |
| A4320 |
Irrigation tray |
1,379 |
1,101 |
$6K |
| A4217 |
Sterile water/saline, 500 ml |
114 |
104 |
$6K |
| K0006 |
Heavy duty wheelchair |
138 |
122 |
$6K |
| A7507 |
Integrated filter & holder |
527 |
422 |
$5K |
| B4152 |
Ef calorie dense>/=1.5kcal |
1,842 |
1,394 |
$4K |
| E1226 |
Manual fully reclining back |
252 |
238 |
$4K |
| E0978 |
W/c acc,saf belt pelv strap |
1,737 |
1,604 |
$4K |
| B4034 |
Enter feed supkit syr by day |
2,395 |
2,302 |
$4K |
| A4628 |
Oropharyngeal suction cath |
1,278 |
1,103 |
$3K |
| A6197 |
Alginate drsg >16 <=48 sq in |
27 |
26 |
$3K |
| A4394 |
Ostomy pouch liq deodorant |
256 |
236 |
$3K |
| A4353 |
Intermittent urinary cath |
15 |
12 |
$3K |
| E0621 |
Patient lift sling or seat |
145 |
126 |
$3K |
| T4525 |
Adult size pull-on sm |
321 |
314 |
$3K |
| B9002 |
Enter nutr inf pump any type |
1,661 |
1,595 |
$2K |
| E0973 |
W/ch access det adj armrest |
60 |
40 |
$2K |
| E2361 |
22nf sealed leadacid battery |
29 |
24 |
$2K |
| A7003 |
Nebulizer administration set |
1,462 |
1,368 |
$2K |
| A4371 |
Skin barrier powder per oz |
731 |
678 |
$2K |
| A4367 |
Ostomy belt |
482 |
449 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
2,674 |
2,557 |
$2K |
| A7525 |
Tracheostomy mask |
1,207 |
1,048 |
$2K |
| A4483 |
Moisture exchanger |
161 |
155 |
$2K |
| B4149 |
Ef blenderized foods |
1,713 |
1,104 |
$1K |
| A7012 |
Nebulizer water collec devic |
540 |
466 |
$1K |
| E0100 |
Cane adjust/fixed with tip |
57 |
56 |
$1K |
| T4531 |
Ped size pull-on sm/med |
12 |
12 |
$791.50 |
| B4154 |
Ef spec metabolic noninherit |
56 |
48 |
$788.73 |
| A4595 |
Tens suppl 2 lead per month |
96 |
62 |
$720.69 |
| A4424 |
Ost pch drain w bar & filter |
14 |
13 |
$691.20 |
| B4155 |
Ef incomplete/modular |
1,208 |
1,008 |
$626.98 |
| A4450 |
Non-waterproof tape |
427 |
368 |
$581.62 |
| A4314 |
Cath w/drainage 2-way latex |
30 |
24 |
$515.58 |
| E0244 |
Toilet seat raised |
14 |
12 |
$477.13 |
| A4311 |
Catheter w/o bag 2-way latex |
188 |
104 |
$467.01 |
| E0443 |
Portable 02 contents, gas |
961 |
773 |
$395.67 |
| A4322 |
Irrigation syringe |
30 |
27 |
$373.95 |
| A4618 |
Breathing circuits |
27 |
24 |
$283.19 |
| A4344 |
Cath indw foley 2 way silicn |
47 |
39 |
$241.26 |
| E0241 |
Bath tub wall rail |
15 |
15 |
$240.10 |
| A7007 |
Lg vol nebulizer disposable |
72 |
61 |
$215.05 |
| A4369 |
Skin barrier liquid per oz |
132 |
117 |
$212.24 |
| A4334 |
Urinary cath leg strap |
182 |
121 |
$174.01 |
| B4153 |
Ef hydrolyzed/amino acids |
423 |
389 |
$162.61 |
| A7036 |
Pos airway press chinstrap |
18 |
17 |
$109.68 |
| E0730 |
Tens four lead |
12 |
12 |
$107.43 |
| A4331 |
Extension drainage tubing |
40 |
24 |
$93.48 |
| A9900 |
Supply/accessory/service |
84 |
80 |
$47.32 |
| E0159 |
Brake for wheeled walker |
17 |
16 |
$36.35 |
| A4332 |
Lube sterile packet |
15 |
13 |
$16.07 |
| A4456 |
Adhesive remover, wipes |
21 |
14 |
$0.11 |
| B4104 |
Additive for enteral formula |
1,137 |
1,013 |
$0.00 |
| B4158 |
Ef ped complete intact nut |
44 |
40 |
$0.00 |
| B4036 |
Enteral feed sup kit grav by |
12 |
12 |
$0.00 |
| B4103 |
Ef ped fluid and electrolyte |
77 |
65 |
$0.00 |